[HEATHER]

They will pay for a transport chair "in lieu of a regular wheelchair." They
do pay - but not much. They used to allow about $43 for the first 3
months - but years ago said that that allowable amount incorrectly included
the price for ELR's too and that the correct allowable is really $18.93/mo
for the first 3 months and $14.20/mo after that (Reg C). We bill the
patient $35 a month and bill unassigned for them. I've caught some
suppliers billing them as K0004's and E1031's - which is wrong.

[HEATHER]

Oh and they will not pay for a cushion with an E1038, period. Just FYI.

[Jamie Hagan]

Thanks Heather

[SimplyLori]

We get requests for transport chairs regularly but it is very RARE to bill MCR because almost all of them are really needed only outside of the home. I tell our patient's and caregivers that in almost 100% of the cases if someone needs their chair in the home they need more support and more options than that what a transport chair can offer.

[Regina]

So, Lori, do you not dispense transport chairs if they are only to be used outside the home? The language seems pretty vague.

[SimplyLori]

If they are only used outside the home we do cash sale only and if they want me to bill MCR we would use GY modifier - statutorily non-covered.