Important Update: Pre-Authorization Requirement for Power Wheelchair Accessories
As of October 1, 2024, CareFirst BCBS implemented a policy requiring prior authorization for a specific power wheelchair accessory. This policy change is specifically unique to the Healthcare Common Procedure Coding System HCPCS Code E2298, which denotes complex rehabilitative power wheelchair accessories; it represents the power seat elevation system.
This mandates health providers to get prior authorization for the accessory E2298 before it is delivered to the patient. This prior authorization process would help assure medical necessity and adherence to policy on the coverage as set out by CareFirst regarding the use of apparatuses of this nature. Providers must forward claims to CareFirst for review and approval before the provision of such accessories.
This newest requirement is part of CareFirst’s ongoing efforts to contain healthcare costs, ensure that services and equipment provided to members are necessary, and ensure the appropriateness of services and equipment. Providers should be aware of the change and take all measures to prevent delays in patient care.
Additional information can be found on CareFirst’s website for providers, with specific guidelines on the submission process and related training on the new process to facilitate the navigation of this change. Compliance would be crucial to this change to ensure no lapse in service delivery to the patients.
This kind of information should be communicated to relevant stakeholders, including patients who may be affected, to avoid any glitches in the smooth process of acquiring needed equipment. Health providers should be informed of such changes and should effect the right administrative changes.