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KMAP BULLETIN: Wheelchair Seating Assessments

Date: 06/27/17

KMAP GENERAL BULLETIN 17137

(Updated effective date.)

Effective with the implementation date of July 1, 2017, Physical Medicine and Rehabilitation procedure codes 97542, 97755 and 97760 will be covered as medically necessary for management of wheelchair seating assessments for all Medicaid beneficiaries. Regardless of provider, reimbursement will not exceed $500 per beneficiary per year for seating assessment services.

Reimbursement for wheelchair seating assessments is limited to the following approved Kansas Medicaid Seating Clinic providers:

  • Carney Center Seating Clinic, Wichita, Kansas
  • Children’s Mercy Hospital Seating Clinic, Kansas City, Missouri
  • KU Medical Center Seating Clinic, Kansas City, Kansas

Note: The effective date of the policy is July 1, 2017. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates.

Additional manuals will be updated appropriately, and additional notification will be sent.

For the changes resulting from this provider bulletin and in keeping with current policies and procedures, view the updated DME/Medical Supply Dealer Fee-for-Service Provider Manual and Rehabilitative Services Fee-for-Service Provider Manual.