Know Your Facts:
Respiratory Assist Devices
Published on Fri Aug 29, 2003
A proposed change to the payment category for certain respiratory equipment could mean $30,000 less in payments for one device. Over five years, a supplier receives $36,751.20 from Medicare for a respiratory assist device with bi-level capability and a back-up rate under the frequent and substantial servicing payment category, the Centers for Medicare & Medicaid Services says in its proposed rule to change the device's category to capped rental. Under the rental category, payment for that same period of time would be only $7,778.99, CMS notes. Following are some other facts CMS cites in its proposed rule for reducing payment for these RADs: Medicare payments for HCPCS code K0533, which covers these devices, reached $77 million in 2002. An $11.5 million reduction to that figure translates to a 15 percent cut in payments for the devices. Medicare beneficiaries use between 10,000 and 12,000 of these RADs per year. The average length of use is 16 months. The top five suppliers of these devices receive $4 million in Medicare payments for them per year.
