The Coalition to Modernize Medicare Coverage of Mobility Products (CMMCMP) Clinician Task Force submits to the CMS Interagency Task Force the following document for consideration during the agency’s review of coverage of mobility products. The goal of the clinician task force is to provide CMS with an objective and consistent process by which medical necessity may be determined and documented.

The core concepts of this proposal are basic. They rely on a knowledgeable and trained clinician (i.e. a physician, physical therapist or occupational therapist) to perform a face-to-face evaluation of the patient’s functional abilities and needs. The comprehensiveness of the evaluation (basic, intermediate, or extensive) and the number of clinical professionals involved depends on the medical complexity and functional needs of the patient. The evaluation results in the clinical determination of the patient’s functional mobility level. The next step involves matching the patient to the technology by considering additional requirements that will further determine specific equipment features required (clinical indicators). The functional mobility levels and clinical indicators lead to a determination of the specific equipment the patient requires (HCPCS Code).

You may download and review the full report here.  CMMCMP Final Recommendations 083104

Laura On August - 3 - 2004

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