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AI Summary This summary was generated by AI from the bill text. AI can get information wrong.
This bill would change how Medicare pays for certain ultralightweight manual wheelchairs. Starting in 2026, Medicare would use separate billing codes depending on what the wheelchair base is made of, including a separate category for chairs made with titanium or carbon fiber. The goal is to make payment rules clearer for these wheelchairs and help patients understand any extra costs they may have to pay if they choose a more expensive model.
- Medicare would have to create at least two billing codes for these wheelchairs: one or more for bases made with titanium or carbon fiber, and one or more for bases made without those materials.
- If a person buys or rents a wheelchair with a titanium or carbon fiber base, Medicare would pay the supplier under the usual payment rules for that type of chair.
- The supplier could charge the person the difference between the Medicare payment and the full price of the wheelchair.
- The government could require suppliers to give the person a notice ahead of time explaining possible out-of-pocket costs before the wheelchair is purchased or rented.
Official Summaries
Choices for Increased Mobility Act of 2025
This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish specific billing codes under Medicare for certain materials used in ultralightweight manual wheelchairs.
Specifically, the CMS must establish at least two billing codes for the base of the wheelchair, with at least one code for a base with titanium or carbon fiber construction material and at least one code for a base without these materials. Suppliers receive the same payment under Medicare for these wheelchairs as would otherwise apply, but may bill beneficiaries for any difference between the payment and the actual charge for the wheelchair. The CMS may require suppliers to inform beneficiaries of their potential financial liability in these cases.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 247 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 247
To amend title XVIII of the Social Security Act to clarify payment
rules for manual wheelchairs under part B of the Medicare program.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 24, 2025
Mrs. Blackburn (for herself and Ms. Duckworth) introduced the following
bill; which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to clarify payment
rules for manual wheelchairs under part B of the Medicare program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Choices for Increased Mobility Act
of 2025''.
SEC. 2. SPECIAL RULES RELATED TO TREATMENT OF CERTAIN MANUAL
WHEELCHAIRS UNDER THE MEDICARE PROGRAM.
Section 1834(a) of the Social Security Act (42 U.S.C. 1395m(a)) is
amended by adding at the end the following new paragraph:
``(23) Special rules related to treatment of certain manual
wheelchairs.--
``(A) Requirement to establish separate hcpcs codes
for certain manual wheelchairs.--With respect to
ultralightweight manual wheelchairs payable under this
subsection furnished on or after January 1, 2026, the
Secretary shall establish two or more HCPCS codes, as
determined appropriate by the Secretary, for the base
of such a wheelchair depending on the construction
material used in such base (with 1 or more such codes
for such a base with titanium or carbon fiber
construction material and 1 or more such codes for such
a base without such materials).
``(B) Payment and beneficiary protections.--
``(i) Payment.--On or after January 1,
2026, in the case where an individual purchases
or rents from a supplier an ultralightweight
manual wheelchair that has titanium or carbon
fiber construction material used in the base of
such wheelchair, payment to the supplier shall
be made in the frequency and amount as would
otherwise be made under this subsection (as
described in paragraph (1)(A)) for such
wheelchair.
``(ii) Beneficiary charges.--The supplier
may charge the individual the difference
between the payment amount described in clause
(i) for such wheelchair and the supplier's
actual charge for such wheelchair.
``(iii) Beneficiary protections.--In order
to inform an individual of their potential
financial liability under clause (ii), the
Secretary may require a supplier to issue a
notice to the individual (in a form and manner
determined by the Secretary) prior to the
purchase or rent of such ultralightweight
manual wheelchair by such individual.''.
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