You may have missed it … Back in January, the DME MACs published a joint reminder that Medicare requires in-person home assessments before billing for manual wheelchairs. I suspect this will catch a lot of suppliers off guard.

Next Episode: Thursday, June 20, 2024

The Policy Article is Vague Supplier confusion is understandable because the relevant wording in the Manual Wheelchair Bases Policy Article is a bit confusing. It reads:
“When the home assessment is based upon indirectly obtained information, the supplier must, at the time of delivery … [address] issues such as the physical layout of the home, surfaces to be traversed, and obstacles …”
I think a reasonable supplier could read that to mean that no additional documentation is required if there are no new issues discovered at delivery that have not already been addressed in the indirect assessment. In this recent bulletin, however, Medicare clarifies that indirect assessments are suitable to expedite delivery, but they do not diminish the supplier’s responsibility to document an in-person assessment before submitting claims. Home Assessment Requirements As a reminder, the purpose of the home assessment is to gather information about the patient’s home and confront any obstacles that will impact their use of the wheelchair to accomplish daily living activities. Assessments may include descriptions of:
  • Doorway widths.
  • Floor surfaces.
  • Number and location of steps.
Going forward, this bulletin remedies any reasonable confusion and explicitly states the DME MACs’ positions on indirect home assessments. Forward this message to your billing team and delivery techs and update your procedures to ensure compliance.