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June 29, 2021 - Updated July 15, 2021

KU Modifier for Accessories Used in Conjunction with Complex Rehabilitative Manual Wheelchairs and Certain Other Manual Wheelchairs

Beginning July 1, 2021, the Centers for Medicare & Medicaid Services (CMS) is continuing the payment rates established by section 106 of the Further Consolidated Appropriations Act, 2020 (FCAA), which excludes wheelchair accessories and back and seat cushions used with FCAA-related manual wheelchairs from the application of adjusted fee schedule amounts. Therefore, effective July 1, 2021, the fee schedule amounts for wheelchair accessories and back and seat cushions furnished in connection with manual wheelchair codes E1161, E1231, E1232, E1233, E1234 E1235, E1236, E1237, E1238, K0005 and K0008 will be based on the unadjusted fee schedule amounts updated by the covered item updates specified in section 1834(a)(14) of the Act. Suppliers should continue using the KU modifier on claims for accessories and seat and back cushions furnished in connection with the above wheelchair base codes on or after July 1, 2021.

This change will not impact the July 2021 DMEPOS fee schedule.

For a complete list of the manual wheelchair accessory codes eligible for the KU modifier effective for dates of service on or after January 1, 2020, see Attachment AExternal PDF of CMS Change Request 11635, Transmittal 10019, issued on May 7, 2020.

July 15, 2021 Update: Suppliers can also refer to MLN Matters Article MM12345External PDF.

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