Mileage Reimbursement
JIM Marshall
Description
Collection
Title:
Mileage Reimbursement
Creator:
JIM Marshall
Date:
8/31/2009
Text:
Thank you to those who replied to my question regarding mileage reimbursement.
I received replies from six respondents indicating that travel reimbursement was not possible from Medicare. Three of these responses were actually a bit condescending and mocking, i.e. Ain't gonna happen, excuse me....but are you high?, etc.
Two respondents requested that I post any positive replies.
The one helpful and definitive reply that I received was from Craig R. DeCamp, CPO who provided the following information:
Travel Charges Associated with Repairing DMEPOS Items:
National Government Services has received questions regarding reimbursement for travel cost associated with in home repairs for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items. On December 23, 2008, the Centers for Medicare & Medicaid Services (CMS) released revisions to the labor payment rates associated with repairing DMEPOS items in Change Request 6297. The revised labor payment rates apply to Healthcare Common Procedure Coding System (HCPCS) codes E1340, L4205 and L7520. In this Change Request, CMS advises that under the previous updates to labor payment rates, annual inflation adjustments were not applied consistently from state to state. This was due to rates being established based on historic supplier charges, which may or may not have included annual inflation adjustments. The new rates established for codes E1340, L4205, and L7520 are based upon 25 percent of the previous hourly rate for codes E1350, L4200, and
L7500 respectively.
As indicated above, the previous labor payment rates were based upon the supplier’s historic charges. Travel costs are assumed to have been taken into account by suppliers in setting the prices they charged for these services under these codes. Therefore, because the cost for travel time has already been accounted for in the calculation of the rates for codes E1340, L4205, and L7520, separate payment shall not be made for travel cost associated with repairing DMEPOS items.
If a supplier chooses to bill separately, code A9901 (DME delivery, set‐up, and/or dispensing service component of another HCPCS code) must be used. This code will auto deny as a contractual obligation (CO) denial. Suppliers may not bill Medicare beneficiaries directly for travel charges.
Change Request 6297 contains specific instructions regarding the revisions to the labor payment rates associated with repairing DMEPOS items. Suppliers may review Change Request 6297 in its entirety at www.cms.hhs.gov/transmittals/downloads/R421OTN.pdf.
The payment calculation for labor payment rates associated with repairing DMEPOS items is not new to the Medicare Fee schedule. Suppliers may also reference TriCenturion’s October 2007, DME program safeguard contractor (PSC) bulletin article titled “FAQ Repair and Replacement.” This article provides additional clarification as to what cost are included in the reimbursement for labor. To view this article please visit the National Government Services Web site at www.ngsmedicare.com/ngsmedicare/DMEMAC/EducationandSupport/ToolsandMaterials/pdf/Repairandreplacement.pdf.
Craig also sent out the above link to the OandP-List.
Thank you for your feedback and information.
Jim Marshall, Owner
Collier Rehabilitation Systems
Pleasant Hill, CA
I received replies from six respondents indicating that travel reimbursement was not possible from Medicare. Three of these responses were actually a bit condescending and mocking, i.e. Ain't gonna happen, excuse me....but are you high?, etc.
Two respondents requested that I post any positive replies.
The one helpful and definitive reply that I received was from Craig R. DeCamp, CPO who provided the following information:
Travel Charges Associated with Repairing DMEPOS Items:
National Government Services has received questions regarding reimbursement for travel cost associated with in home repairs for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items. On December 23, 2008, the Centers for Medicare & Medicaid Services (CMS) released revisions to the labor payment rates associated with repairing DMEPOS items in Change Request 6297. The revised labor payment rates apply to Healthcare Common Procedure Coding System (HCPCS) codes E1340, L4205 and L7520. In this Change Request, CMS advises that under the previous updates to labor payment rates, annual inflation adjustments were not applied consistently from state to state. This was due to rates being established based on historic supplier charges, which may or may not have included annual inflation adjustments. The new rates established for codes E1340, L4205, and L7520 are based upon 25 percent of the previous hourly rate for codes E1350, L4200, and
L7500 respectively.
As indicated above, the previous labor payment rates were based upon the supplier’s historic charges. Travel costs are assumed to have been taken into account by suppliers in setting the prices they charged for these services under these codes. Therefore, because the cost for travel time has already been accounted for in the calculation of the rates for codes E1340, L4205, and L7520, separate payment shall not be made for travel cost associated with repairing DMEPOS items.
If a supplier chooses to bill separately, code A9901 (DME delivery, set‐up, and/or dispensing service component of another HCPCS code) must be used. This code will auto deny as a contractual obligation (CO) denial. Suppliers may not bill Medicare beneficiaries directly for travel charges.
Change Request 6297 contains specific instructions regarding the revisions to the labor payment rates associated with repairing DMEPOS items. Suppliers may review Change Request 6297 in its entirety at www.cms.hhs.gov/transmittals/downloads/R421OTN.pdf.
The payment calculation for labor payment rates associated with repairing DMEPOS items is not new to the Medicare Fee schedule. Suppliers may also reference TriCenturion’s October 2007, DME program safeguard contractor (PSC) bulletin article titled “FAQ Repair and Replacement.” This article provides additional clarification as to what cost are included in the reimbursement for labor. To view this article please visit the National Government Services Web site at www.ngsmedicare.com/ngsmedicare/DMEMAC/EducationandSupport/ToolsandMaterials/pdf/Repairandreplacement.pdf.
Craig also sent out the above link to the OandP-List.
Thank you for your feedback and information.
Jim Marshall, Owner
Collier Rehabilitation Systems
Pleasant Hill, CA
Citation
JIM Marshall, “Mileage Reimbursement,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 8, 2024, https://library.drfop.org/items/show/230643.
