Medicare Capped Rental: What is it and how does it affect me?

Mar 07, 2014 | by Lisa Haynes, MS, CCC-SLP

The speech-language community is buzzing with talk about a new term, “capped rental.” You may have heard from a colleague or peer that capped rental is going to impact Alternative and Augmentative Communication (AAC) devices. While this is true, we are here to help clarify what this change means for you and your clients.

First and foremost, what is capped rental?

Capped rental is one of five payment categories that the Centers for Medicare and Medicaid Services (CMS) use for reimbursement of durable medical equipment (DME). This category includes items like wheelchairs, hospital beds, and suction machines. As of April 1, 2014, speech-generating devices (SGDs) will become a capped rental item.

What does this mean for my practice?

For speech-language pathologists (SLPs), the only thing that changes is how reimbursement is explained to your clients. As always, Lingraphica will help with this conversation. We have resources in place to walk your clients through the reimbursement process. The most important thing to remember is that on April 1, all SGDs reimbursed by CMS will be part of a 13-month rental period, at the end of which your client will own the device. It’s important to note that this only applies to your clients who use Medicare as their primary insurance. Your clients receiving an SGD for the first time will not notice a change, as this is their first time through the process. Lingraphica will continue to speak directly with your client and his/her caregiver to help explain insurance coverage and benefits prior to and during the rental period.

What stays the same with capped rental?

SLPs and their clients can still expect: a free trial of a speech-generating device, eligibility for ASHA CEUs (for SLPs), unlimited training and technical support, and a fully customized SGD for their clients.

What is Lingraphica doing to help?

LOTS! Right now, we are offering free webinars to help increase the awareness and understanding of capped rental. We are also adding support in the form of a new program. This educational program is going to help your clients use their devices for functional communication by promoting communication between Lingraphica, your client, and their caregiver. The program provides very specific exercises and activities to achieve functional communication as early as day one. It will embrace the individual needs of your clients and allow them to work at their own pace. Finally, the program is accommodating to caregivers and other healthcare professionals.

I hope I answered all of your questions about capped rental. If Lingraphica can assist you in any way during this process, please contact us on our toll free line at 888-274-2742 or email us at info@lingraphica.com. If you’re working on a trial now, get your paperwork in by March 17 so you can complete the SGD process before capped rental takes effect on April 1. You can also reach out to your Clinical Consultant, who can answer any questions you have about capped rental.

Be on the lookout for our new educational program. We’ll have more exciting information to share soon.