Hi Amy,
Good info. Thanks. I downloaded the Medicare Reimbursement Form.
When you say Medicare would only provide this benefit "once in a lifetime" does that refer to a possible future purchase of an SGD? Or does it only refer to reimbursing for an under $200 out-of-pocket cost?
Might a patient find that Medicare has reimbursed them for a $200 app and later, when they need a $16,000 eye tracking SGD, they may be told we already addressed your ALS diagnosis related communication need? I remember this was an issue with voice amplifiers funded by Medicare.Sincerely,Amy Roman, MS, CCC-SLPAugmentative Communication SpecialistAmyandpALS.ComForbes Norris ALS Research and Treatment Center2324 Sacramento StreetSan Francisco, CA 94115Cell (415)518-0592Fax (415)600-3778From: AMY S. GOLDMAN <xxxxxx@temple.edu>Subject: Re: [no phi] RE: how to bill insurance for apps or TTS software for a computerTo: xxxxxx@alsa.simplelists.comDate: Monday, June 24, 2013, 9:17 AM
I had a similar inquiry (from Philly) and here's what I advised the therapist below. Please note that she told me when she pursued the "reimbursement" option, Medicare told her the consumer could only do this literally once in a lifetime (for items under $200).
Questions about Medicare:
http://www.medicare.gov/claims-and-appeals/file-a-claim/file-a-claim.html
There is a form for a person to file for reimbursement, themselves - if they are in "original Medicare".
http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH.pdf
Keep in mind that if the patient is
in a Medicare managed care plan, process will be different, and they should contact their plan.
You may want to contact the "DMERC" that handles durable medical equipment for our region.
Of course they will not cover the ipad but may, under that "E" CPT code I referenced in my asha post, cover the app as a specialized software - and you can ask if reimbursement for that is a possibility. (And please let me know what you find out!!)
HealthNow NY
Region A DMERC
P.O. Box 6800
Wilkes-Barre, PA 18773
Phone: (800)842-2052 begin_of_the_skype_highlighting (800)842-2052
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On Mon, Jun 24, 2013 at 11:27 AM, Edward Hitchcock <xxxxxx@ric.org> wrote:
I know that Forbes rehabilitation services is now selling an iPad with speech apps under Medicare benefits.
http://www.frs-solutions.com/products/comlinks/proslates/ProSlate_10
I do not know of anyone who is selling just the apps under Medicare assignment. Practically speaking, I have a hard time imagining that happening since it is so much money to get funding through Medicare compared to the relatively low cost of the apps themselves. But then again, I obviously do not have much experience with that side of the business so perhaps there are people out there who are?
Ed Hitchcock OT/L
Technology Center
Rehabilitation Institute of Chicago
Does anyone know how to do this? My patients have been paying for TTS apps privately but it is a Medicare benefit. How can they use this benefit?
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