4-11-07
AOTA Advocating for Alternate Medicare Options of OTs Performing Power Mobility Specialty Evaluations
AOTA is developing an alternative option to the RESNA certification requirement, which may include a list of criteria that an OT could meet to qualify for payment for Power Mobility Device (PMD) evaluation services. In the past, when providers have been required to demonstrate special knowledge or skills, CMS has accepted completion of certain competencies as meeting reimbursement requirements rather than requiring a particular certification exam. AOTA has established a panel of OT clinicians with expertise in PMDs to help develop the criteria.
Ultimately, AOTA's goal is to have CMS revise the Medicare local coverage determination (LCD) policy based on AOTA's criteria. Whatever the outcome, AOTA will continue to work closely with CMS and RESNA to ensure that clients' needs are met and OT practitioners' ability to provide—and receive payment for—PMD services is protected.
In the meantime, OTs concerned about the certification requirement for PMD services can advocate for the profession and their clients by writing to their local Durable Medical Equipment Medicare Administrative Contractor (DME MAC) medical director. The DME MAC medical directors are responsible for writing LCDs for the regions they oversee.
There are four DME MACs nationally: AdminaStar Federal Inc., National Heritage Insurance Company, CIGNA Government Services, and Noridian Administrative Services. AOTA has published a Capital Briefing article in OT Practice with more details about the Medicare power mobility LCD affecting OTs.
