Medicare Program; Payment for Respiratory Assist Devices With Bi-Level Capability and a Backup Rate
medicare · Centers for Medicare and Medicaid Services · Rule · Published 2006-01-27 · Effective 2006-04-01 · 71 FR 4518
Document
Document number
06-798
Federal Register citation
71 FR 4518
CFR reference
42 CFR 414
Type
Rule
Action
Final rule.
Category
medicare
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2006-01-27
Effective date
2006-04-01
HHS docket
CMS-1167-F
Abstract
This final rule clarifies that respiratory assist devices with bi-level capability and a backup rate must be paid as capped rental items of durable medical equipment (DME) under the Medicare program and not paid as items requiring frequent and substantial servicing (FSS), as defined in section 1834(a)(3) of the Social Security Act. Before 1999, respiratory assist devices with bi-level capability (with or without a backup rate feature) were referred to as "intermittent assist devices with continuous positive airway pressure devices" under the Medicare program and in the Healthcare Common Procedure Coding System (HCPCS). This final rule responds to public comments received on a proposed rule published in the Federal Register on August 22, 2003, and finalizes the policy in that proposed rule. The rule will ensure that respiratory assist devices are consistently and properly paid under Medicare as capped rental items.