New Add-on Code for E/M Visits with Mobility-assisted Technology
Effective January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) proposed that add-on code G0501 could be billed with new and established patient office/outpatient E/M codes (99201-99205 and 99212-99215), as well as transitional care management codes (99495, 99496), when the additional resources described by the code are medically necessary and used in the provision of care.
G0501 Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lifts, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient evaluation and management visit (Add-on code, list separately in addition to primary procedure).
An adjustment to payment for routine visits furnished to beneficiaries for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lifts, and adjustable padded leg supports) is medically necessary.
Although CMS believes that improving the payment accuracy of physicians’ services is necessary and appropriate, and can help to address the underlying access issues for individuals with disabilities, they also acknowledge that implementation of new or revised payments can result in unanticipated, and potentially undesirable, consequences. Before implementing payment for code G0501, CMS plans to further analyze and address the concerns raised. As such, they are not finalizing payment for code G0501, at this time. Over the next six months CMS will engage with interested beneficiaries, advocates, and practitioners to continue to explore improvements in payment accuracy for care of people with disabilities. CMS intends to discuss this issue again in future rulemaking.
Although CMS is not finalizing separate payment for code G0501 for CY 2017, they are including the code in the CY 2017 code set as G0501. The HCPCS code G0501 will not be payable under the Medicare PFS for CY 2017, although practitioners will be able to report the code, should they be inclined to do so.