Why a Separate Benefit Category is Necessary for CRT

Learn more about the difference of DME and CRT and why CRT needs its own benefit category.

Learn more about the difference of DME and CRT and why CRT needs its own benefit category.

 

Complex Rehab Technology (CRT) consists of highly configurable manual and power wheelchairs, adaptive seating and positioning systems, and other specialized equipment that is prescribed to meet the specific medical needs of individuals with disabilities and chronic medical conditions. In Medicare, these highly specialized products are still categorized under the broad durable medical equipment (DME) benefit category.  The DME benefit category was created over forty years ago to support the medical equipment needs of elderly individuals. Those who are educated and exposed to CRT know that CRT products are NOT the same as DME. Because CRT is categorized under Medicare’s DME benefit category, CRT products are not properly differentiated which prevents focused policies and safeguards. A separate benefit category for CRT would better address the needs of the individuals who use CRT products.

Below are more reasons why Complex Rehab Technology (CRT) equipment is different than broad durable medical equipment (DME) and support why CRT products should have a separate benefit category:

Population Served – CRT is used with individuals who have significant disabilities and medical conditions. DME is typically used for elderly populations. CRT users generally only qualify under Medicare’s DME benefit category because of their disability, and the category does not support their age.

CRT Services – CRT requires a broader range of services and specialized personnel than standard DME. The specialized devices in CRT alone require specific assessments, trials, fitting, and user education that most DME products do not. CRT also requires a group of highly specialized medical professionals.

CRT Devices – As already mentioned, CRT devices require specialized evaluations, assessments, measurements, fittings, trials, training and educations, and ongoing modifications.

Comprehensive Quality Standards – Medicare has established quality standards for all DME companies who wish to participate in the Medicare program. CRT companies are included under these DME standards and also must comply with additional, more rigorous standards.

The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 (H.R. 942 and S. 948) would establish a separate benefit category for CRT products and services within the Medicare program. This Act would then recognize CRT and better address the unique needs of individuals with disabilities and chronic medical conditions who require these specialized products and services.

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