American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

Getting paid for mobility

From the October ACP Observer, copyright 2007 by the American College of Physicians.

PMC TipsMedicare pays for documenting the medical necessity of power-operated wheelchairs and scooters. Yes, Medicare pays physicians, PAs or NPs when they prescribe a power mobility device (PMD). The payment is for completing the form, not for assessing the patient.

In order to collect the Medicare payment, the physician must communicate to a durable medical equipment (DME) supplier that they certify a patient needs a power-operated scooter or power wheelchair. This add-on payment reimburses physicians for the time and resources used to complete and submit the required medical record documentation to the supplier.

The Centers for Medicare and Medicaid Services rules pertaining to Medicare coverage and payment for power mobility devices include several changes from previous rules.

  • Physicians, PAs or NPs are required to examine the patient face-to-face to evaluate the medical necessity of a power mobility device. Medicare pays physicians for that face-to-face examination through the appropriate E&M code for the level of service rendered.
  • Physicians must submit supporting medical record documentation of the face-to-face examination that justifies the written prescription. Using copies of the medical record, which the physician already needs to maintain, as confirmation of medical necessity avoids additional paperwork. Physicians no longer have to submit the certificate of medical necessity form.
  • Practices should bill using Healthcare Procedural Coding System code G0372 in addition to the E&M code.

Replacing the certificate of medical necessity submission requirement with both the face-to-face examination and documentation submission requirements is meant to reduce fraudulent billing by DME suppliers. These regulations prohibit suppliers from delivering power mobility devices to beneficiaries without receipt of a written prescription and supporting medical record documentation.

For more information on receiving payment for documentation of power mobility devices as well as other Medicare payment regulations, check out the Practice Management Center’s Web site.

PMC Tips is a regular feature on small-practice management from ACP's Practice Management Center.

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Advertisement

Share

 
 

Internist Archives Quick Links

What will you learn from your Annals Virtual Patient?

Annals Virtual Patient

Annals Virtual Patients is a unique patient care simulator that mirrors real patient care decisions and consequences. CME Credit and MOC Points are available. Start off with a FREE sample case. Start your journey now.

Internal Medicine Meeting 2015 Live Simulcast!

Internal Medicine Meeting 2015 Live Simulcast

Unable to attend the meeting this year? On Saturday, May 2, seven sessions will be streamed live from the meeting. Register for the simulcast and earn CME credit after watching each session. Watch it live or download for later viewing.