CRT Accessory Exemption Estimated at $170 Million

After permanently ending the application of bid pricing to CRT accessories, CMS provides estimates of the positive impact for suppliers in its final rule.

• By David Kopf
• Aug 05, 2021

After permanently ceasing the application of competitive bidding-derived reimbursement rates to accessories for complex rehab technology (CRT) wheelchairs last week, CMS also tallied up the projected the increased payments to CRT suppliers in its final rule and amounts are substantial.

According to CMS’s final rule, the agency estimated that suppliers of accessories for power CRT wheelchairs should see $130 million in increased payments from the Federal FY 2022 to FY 2026, and suppliers of accessories for manual CRT wheelchairs should see $40 million in increased payments for the same period.

The estimated $170 million in upside over the next five years is in addition to hundreds of millions of dollars that were retained thanks to delaying the application of bid-derived reimbursement since 2016, as well as the permanent exemption for power CRT accessories achieved in 2017.

A Protracted Battle Finally Ends

The fight to exempt accessories for complex rehab wheelchairs has been going on since 2015, when CMS expanded competitive bidding nationally, and in so doing, announced it would also apply its bid pricing scheme to CRT accessories.

For CRT stakeholders and advocates, this ran in the face of the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) in 2008, which carved out CRT from the competitive bidding program.

However, CMS argued that while the language of MIPPA carved out the chairs from bidding, it didn’t remove the accessories.

From that point forward, a wide coalition of industry and patient organizations worked to reverse the policy: the National Coalition of Assistive & Rehab Technology (NCART); the American Association for Homecare (AAHomecare); the National Registry of Rehabilitation Technology Suppliers (NRRTS); U.S. Rehab, Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), the ITEM Coalition, United Spinal Association, Paralyzed Veterans of America, the ALS Association, the Christopher and Dana Reeve Foundation, the Spina Bifida Association, the Center for Medicare Advocacy, and the Clinician Task Force.

With the prolonged fight to protect CRT accessories finally over, key leaders in the effort are breathing a sigh of relief.

“This outcome was the result of several years of collaborative advocacy within the CRT Community to ensure these damaging cuts did not go into effect,” NCART Executive Director Don Clayback said. “We want to thank Reps. John Larson (D-CT) and Lee Zeldin (R-NY), and Sens. Bob Casey (D-PA) and Rob Portman (R-OH), for their ongoing leadership and support.”

“Persistence and passion; that’s what it takes to succeed on Capitol Hill,” AAHomecare President and CEO Tom Ryan noted. “The commitment of mobility advocates and our patient group allies to keep the pressure on legislators over several years is inspiring and amazing.”

“The complex rehab wheelchair accessory issue has been a battle since late 2014 and it is great news to finally secure long-term protection for all CRT accessories,” added Seth Johnson, senior vice president of government affairs for Pride Mobility. “While it took a long time to get to the finish, the results are definitely worth the effort.”