Protect CRT and Your Independence for Equipment

Since 2015, a variety of national organizations have been working with the Centers for Medicare and Medicaid Services (CMS) and Congress to stop CMS from inappropriately using Medicare Competitive Bid Program (CBP) pricing to cut payment amounts for accessories used with Complex Rehab wheelchairs. CMS published a policy clarification stating it would not use
CBP pricing for accessories used with Complex Rehab power wheelchairs, but unfortunately did not extend relief to accessories used with Complex Rehab manual wheelchairs.

Congressional action is needed! Legislation has been introduced- H.R. 3730- and we need people from across the country to reach out to their Members of Congress to ask for support and passage of the bill. Go to and send the prepared emails asking for support of the legislation.

Nevada Medicaid Issues

We are working on stories from Service Providers and Patients who are having problems with Nevada Medicaid on these topics.


  1. Children with Special Needs in Rural Areas with Medicaid
    1. No medical physicians to take Pediatrics kids with disabilities in Northern Nevada due to Medicaid Coverage.
  2. Obtaining CRT or DME (Wheelchairs or power wheelchairs)
    1. Denials
    2. Documentation

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CRT National Issue

Get Cosponsors for CRT Manual Wheelchair Accessories Bill

August 30, 2017

CRT Stakeholders and Friends,

We need your Nevada Representative to join in the introduction of new legislation to stop the Medicare cuts to CRT manual wheelchair accessories.  Nevada Representatives are always supportive to CRT.

As we reported earlier this month, Representatives Lee Zeldin (R-NY) and John Larson (D-CT) will be introducing NEW legislation in September to stop CMS’ application of Medicare Competitive Bid pricing to accessories used with CRT manual wheelchairs.

Representatives Zeldin and Larson are seeking additional House members to join them in the September introduction. You can see the list of members who have already agreed to be an original cosponsor here.

If your Representative is not on the list, please reach out and ask him/her to sign on by contacting either office. Use the Issue Paper available here to make your request.  The new legislation to be introduced can be found here.

What is Complex Rehab Technology

What is Complex Rehab Technology (CRT)?

CRT is any-part of the wheelchair that was made to fit the person’s unique needs from the base of the wheelchair up or frame.

Complex Rehab Technology Defined

 The Products

Complex Rehab Technology (CRT) products and associated services include medically necessary, individually configured devices that require evaluation, configuration, fitting, adjustment or programming. These products and services are designed to meet the specific and unique medical,

physical, and functional needs of an individual with a primary diagnosis resulting from a congenital disorder, progressive or degenerative neuromuscular disease, or from certain types of injury or trauma. For purposes of this document, CRT refers to individually configured manual wheelchair systems, power wheelchair systems, adaptive seating systems, alternative positioning systems and other mobility devices.

The Person

These products and services are designed to meet the specific and unique medical and functional needs of an individual with a primary diagnosis resulting from a congenital disorder, progressive or degenerative neuromuscular disease, or from certain types of injury or trauma. The primary diagnoses that can require CRT include:

  • Spinal Cord Injury; or
  • Anterior horn cell diseases; or
  • Traumatic Brain Injury; or
  • Post‐Polio Syndrome; or
  • Cerebral Palsy; or
  • Cerebellar degeneration; or
  • Muscular Dystrophy; or
  • Dystonia; or
  • Spina Bifida; or
  • Huntington’s disease; or
  • Osteogenesis Imperfecta; or
  • Spinocerebellar disease; or
  • Arthrogryposis; or
  • Certain types of amputation; or
  • Amyotrophic Lateral Sclerosis; or
  • Paralysis or paresis; or
  • Multiple Sclerosis; or
  • Demyelinating diseases; or
  • Myelopathy; or
  • Myopathy; or
  • Progressive Muscular Atrophy; or
  • Other disability or disease that is determined through individual consideration to require the use of such individually configured products and services

The Process

In establishing a person’s need for CRT products and services, consideration is always given to the person’s immediate and anticipated medical and functional needs. These needs include, but are not limited to, activities of daily living (ADLs), instrumental activities of daily living (IADLs), functional mobility, positioning, pressure redistribution, and communication. CRT is used to address these needs and enable the individual to accomplish these tasks safely, timely, and as independently as possible in all environments the individual is expected to encounter.

The provision of CRT consists of two interrelated components:

  • The clinical component of providing CRT includes the physical and functional evaluation, treatment plan, goal setting, preliminary device feature determination, trials/simulations, fittings, function related training, determination of outcomes and related follow‐up. The clinical team is responsible for the prescription and supporting medical documentation.
  • The technology‐related component of providing CRT includes, as appropriate: accessibility survey of the home environment; transportation assessment; technology assessment; equipment demonstration/trial/simulation; product feature matching to identified medical, physical, and functional needs; system configuration; fitting; adjustments; programming; and product related training and follow‐up.

 The Professionals

The provision of CRT is done through an interdisciplinary team consisting of, at a minimum, a Physician, a Physical Therapist or Occupational Therapist, and a Rehab Technology Professional (referred to as the CRT Team). The team collectively provides clinical services and technology related services. An individual’s medical and functional needs are identified by the clinical team. These needs are then matched to products and configured into custom designed systems by the

Rehab Technology Professional with input from the clinical team.

  • The clinical CRT services are provided by a licensed/certified Physical Therapist or Occupational Therapist.
  • The technology‐related CRT services are provided by a certified, registered or otherwise credentialed Rehab Technology Professional.

 The Credentials

CRT products must be provided by individuals who are certified, registered or otherwise credentialed by recognized organizations in the field of CRT and who are employed by a business specifically accredited by a CMS deemed accreditation organization to provide CRT.

Source NARTS 2016