Mar 21, 2023

Power seat elevation on power wheelchairs now covered as DME in ‘landmark’ CMS decision

For the first time ever, power seat elevation on power wheelchairs will be covered as durable medical equipment through the Medicare program, according to a benefit category determination and national coverage decision issued Tuesday by the Centers for Medicare & Medicaid Services.

Effective immediately, seat elevation for Medicare-covered power wheelchairs is considered a clinically meaningful benefit for Medicare beneficiaries who perform transfers from power wheelchairs or use the wheelchairs for mobility-related activities of daily living such as dressing, grooming, toileting, feeding and bathing, the agency said. Conditions apply.

"For too long, many people who use a power wheelchair could not access everyday items in their homes and may have struggled to get in and out of their device," CMS Administrator Chiquita Brooks-LaSure said in a statement. "This landmark Medicare decision to cover seat elevation is a major milestone that will improve the quality of life for so many who rely on this technology."

CMS accepted a formal request from the Independence Through Enhancement of Medicare and Medicaid Coalition to consider a benefit category and coverage of the equipment earlier this year. Previously, the agency did not consider the equipment to be a statutorily covered option. Based on the comments it received and the evidence the agency reviewed, however, CMS determined that the equipment serves a medical purpose in assisting with transfers in and out of power wheelchairs and with performing reaching activities.

For additional information, see the decision summary and memo.