What is Complex Rehab Technology (CRT)?

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.