CMS proposes expanding mobility benefit 

WASHINGTON – CMS has released a proposed national coverage determination decision that would, for the first time, expand coverage for power seat elevation equipment on certain power wheelchairs to Medicare beneficiaries. 

The agency has also initiated a 30-day public comment period. 

“Millions of people with Medicare rely on medically necessary assistive devices to perform daily tasks that directly impact their quality of life,” said CMS Administrator Chiquita Brooks-LaSure. “CMS remains committed to ensuring persons with disabilities are receiving available benefits that improve their health. Today’s proposal promotes a first of its kind benefit expansion providing people with Medicare additional tools to improve their lives.” 

If finalized, power seat elevation equipment would be covered by Medicare for individuals with a Group 3 power wheelchair to improve their health as they transfer from the wheelchair to other surfaces. 

The proposed NCD follows an evidence-based clinical analysis that CMS initiated in August 2022 to examine whether the use of power seat elevation equipment on power wheelchairs: 1) falls within a Medicare benefit category and 2) if yes, whether it is reasonable and necessary. 

CMS encourages comments from all interested parties, in particular, people with Medicare and their families, providers, clinicians, consumer advocates, health care professional associations, and from individuals serving populations facing disparities in health and health care. Additionally, the agency is specifically interested in gathering additional scientific literature that provides evidence surrounding the medical necessity for seat elevation systems through studies that include measurable characteristics related to the performance of transfers. 

In September 2020, the ITEM Coalition submitted a request to CMS to reconsider the NCD for mobility assistive equipment to include coverage of seat elevation and standing systems that are embedded in power wheelchairs. In August 2022, the agency moved forward with the process for seat elevation, but not power standing systems.

NCART sent out a bulletin earlier this week that CMS was expected to release the proposed NCD today.