Secretary shall, in consultation with suppliers 
and manufacturers of CRT items— 
‘‘(i) remove from the coding subset for 
durable medical equipment any CRT items 
that are included in the coding subset 
under subparagraph (A); and 
‘‘(ii) assign new codes to such CRT 
items for purposes of including such items 
in the subset under subparagraph (A). 
‘‘(D) NEW TECHNOLOGY.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall update as needed the HCPCS level II 
process used to modify the code set to in-
clude CRT items for the purposes of estab-
lishing new codes and determining prod-
ucts to be classified as CRT items. In de-
termining if a product is a CRT item, the 
Secretary shall consider— 
‘‘(I) if the product is novel; 
‘‘(II) the clinical application of 
the product; and 
‘‘(III) the ability of the product 
to address the unique needs and ca-
pacities of a qualified individual. 
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‘‘(ii) The Secretary shall include the 
codes established in clause (i) in the list 
under section 1861(iii)(2)(F). 
‘‘(E) MISCELLANEOUS CODE FOR INNOVA-
TION
AND
LOCAL
COVERAGE
DETERMINA-
TIONS.—The coding subset established under 
subparagraph (A) shall include at least one mis-
cellaneous code for items not otherwise classi-
fied. 
‘‘(6) REPLACEMENT OF CRT ITEMS.— 
‘‘(A) IN
GENERAL.—Payment shall be 
made for the replacement of a CRT item (or for 
the replacement of any part of such item), with-
out regard to continuous use or useful lifetime 
restrictions 
established 
under 
section 
1834(a)(7)(C) for items of durable medical 
equipment if a qualified ordering practitioner 
determines that the provision of a replacement 
item (or a replacement part of such an item) is 
necessary because of any of the following— 
‘‘(i) a change in the physiological con-
dition of the qualified individual to whom 
such item was provided; 
‘‘(ii) an irreparable change in the con-
dition of the CRT item (or, in the case of 
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the replacement of a part, in the part of 
the CRT item); or 
‘‘(iii) the CRT item requires repairs 
and the cost of such repairs would be more 
than 50 percent of the cost of a replace-
ment of the CRT item. 
‘‘(B) DEFERRAL TO PROVIDERS.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), if a qualified ordering practitioner de-
termines that a replacement of the CRT 
item, or the replacement of a part of a 
CRT item, is necessary pursuant to sub-
paragraph (A), the replacement item or 
part be deemed to be reasonable and nec-
essary 
for 
purposes 
of 
section 
1862(a)(1)(A). 
‘‘(ii) EXCEPTION FOR ITEMS UNDER 3 
YEARS
OLD.—If the CRT item that is 
being replaced (or the part of the CRT 
item that is being replaced) under subpara-
graph (A) is less than 3 years old (cal-
culated from the date on which the quali-
fied individual began to use the CRT item 
or part), the Secretary may require the 
qualified ordering practitioner to provide 
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confirmation of necessity of the replace-
ment item or replacement part, as the case 
may be. 
‘‘(7) PAYMENT FOR TEMPORARY RENTAL.— 
‘‘(A) IN GENERAL.—If a CRT item owned 
by a qualified individual needs to be repaired, 
payment may be made under this subsection for 
the temporary rental of a CRT item while the 
CRT item owned by such individual is being re-
paired. 
‘‘(B) BASIS; LIMITATION.—Payment per-
mitted under subparagraph (A) shall be made 
on a monthly basis, and the period of rental 
may not exceed two months. 
‘‘(C) PAYMENT AMOUNT.—The amount of 
payment allowed under subparagraph (A) for a 
month for the rental of a CRT item shall be 10 
percent of the purchase price for the CRT item. 
‘‘(8) DEFINITIONS.—For purposes of this sub-
section: 
‘‘(A) CRT ITEM.—The term ‘CRT item’ 
has the meaning given such term in section 
1861(iii). 
‘‘(B) HCPCS.—The term ‘HCPCS’ refers 
to the Health Care Procedure Coding System. 
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‘‘(C) QUALIFIED CRT PROFESSIONAL.— 
‘‘(i) IN GENERAL.—The term ‘quali-
fied CRT professional’ means an individual 
who— 
‘‘(I) is certified by the Rehabili-
tation 
Engineering 
and 
Assistive 
Technology Society of North America 
as an assistive technology professional 
or is certified by another organization 
designated by the Secretary (acting in 
consultation with relevant parties) as 
providing a certification that is equiv-
alent to, or more stringent than, the 
assistive technology professional cer-
tification; and 
‘‘(II) beginning two years after 
the establishment of the designation 
under clause (ii), achieves an addi-
tional designation that demonstrates 
the individual’s competencies and ex-
perience in supplying CRT items. 
‘‘(ii) 
ESTABLISHMENT.—Not 
later 
than one year after the date of enactment 
of the Ensuring Access to Quality Complex 
Rehabilitation Technology Act of 2012, the 
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Secretary, acting in consultation with rel-
evant parties, shall establish the additional 
designation under clause (i)(II). 
‘‘(iii) RELEVANT PARTIES.—For pur-
poses of this subparagraph, the term ‘rel-
evant parties’ includes clinicians, consumer 
groups, CRT suppliers, and CRT manufac-
turers. 
‘‘(D) QUALIFIED
CRT
SERVICE
TECHNI-
CIAN.—The term ‘qualified CRT service techni-
cian’ means an individual who— 
‘‘(i) is factory-trained by the manufac-
turers of the CRT items being offered by 
the suppler of such items; 
‘‘(ii) is trained and educated (includ-
ing through on the job training) to assem-
ble, fit, program, service and repair CRT 
items; and 
‘‘(iii) on an annual basis, completes at 
least ten hours of continuing education 
specific to the assembly, fitting, program-
ming, service and repair of CRT items. 
‘‘(E) QUALIFIED INDIVIDUAL.—The term 
‘qualified individual’ has the meaning given 
such term in section 1861(iii)(3)(E). 
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‘‘(F) 
QUALIFIED
ORDERING
PRACTI-
TIONER.—The term ‘qualified ordering practi-
tioner’ means a physician (as defined in section 
1861(r)), a physician assistant, nurse practi-
tioner, or a clinical nurse specialist (as those 
terms are defined in section 1861(aa)(5)).’’. 
SEC. 5. CONFORMING AMENDMENTS. 
(a) EXCLUSION FROM THE IN-HOME USE LIMITA-
TION FOR DME.—Section 1861(n) is amended by adding 
at the end the following: ‘‘For 2013 and subsequent years, 
such term does not include complex rehabilitation tech-
nologies as defined in subsection (iii)’’. 
(b) EXEMPTION
FROM
COMPETITIVE
ACQUISI-
TION.—Section 1847(a)(7) is amended by adding at the 
end the following new subparagraph: 
‘‘(C) CRT ITEMS.—For 2013 and subse-
quent years, complex rehabilitation technology 
items as defined in section 1861(iii).’’. 
(c) EXEMPTION FROM SNF CONSOLIDATED BILL-
ING.—Section 1888(e)(2)(A)(iii) is amended by adding at 
the end the following: 
‘‘(VI) 
Complex 
rehabilitation 
technology items as defined in section 
1861(iii) if delivered to an inpatient 
for use during the stay in the skilled 
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nursing facility as part of the plan of 
care to allow the transition of such 
qualified individuals from the skilled 
nursing facility setting to the home 
and community.’’. 
(d) PAYMENT EXCLUSIONS.—Section 1834(a) of the 
Social Security Act is amended— 
(1) in paragraph (4), by adding at the end the 
following sentence ‘‘For 2013 and subsequent years, 
the items covered by this paragraph shall not include 
complex rehabilitation technology items as defined in 
section 1861(iii).’’; 
(2) in paragraph (7)(A), by adding at the end 
the following: ‘‘For fiscal year 2013 and subsequent 
years, the previous sentence shall not apply to 
power-driven wheelchairs that are designated as 
CRT items under section 1861(iii).’’; and 
(3) in paragraph (16), by inserting at the end, 
after the third sentence, the following: ‘‘The Sec-
retary shall impose (and, may, as allowed by the sec-
ond sentence of this paragraph, waive) the require-
ments of the first sentence of this paragraph to sup-
pliers of complex rehabilitation technology items ex-
cept that, in order to avoid duplicate bonds, the Sec-
retary shall not impose such requirements with re-
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spect to suppliers of complex rehabilitation tech-
nology items when such suppliers also participate in 
the Medicare program as suppliers of durable med-
ical equipment.’’. 
(e) REQUIREMENTS FOR SUPPLIERS OF MEDICAL 
EQUIPMENT
AND
SUPPLIES.—Section 1834(j)(5) is 
amended— 
(1) by redesignating subparagraphs (E) and 
(F) as subparagraphs (F) and (G), respectively; 
(2) by inserting after subparagraph (D) the fol-
lowing new subparagraph: 
‘‘(E) complex rehabilitation technology 
items (as defined in section 1861(iii));’’. 
SEC. 6. EFFECTIVE DATE. 
The amendments made by this Act shall apply to 
items and services furnished on or after January 1, 2013. 
Æ 
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