NSM: ‘It could (become) very rare for a complex power wheelchair not to have seat elevation’

NASHVILLE, Tenn. – Just how big of a deal is Medicare’s new coverage for seat elevation systems for complex power wheelchairs? National Seating & Mobility’s Isaac Rodriguez estimates Medicare is about one-third of the company’s payer volume and about one-third of its clients use power wheelchairs, so a significant number of its clients will most likely qualify for the technology. 

“Seat elevation is already a big deal for power wheelchair users – many of our clients have been self-funding this technology upgrade prior to Medicare’s coverage of this benefit,” said Rodriguez, senior vice president of field operations. “We believe seat elevation is a feature with significant value for our clients. It could be a situation where it’s very rare for a complex power wheelchair user not to have seat elevation on their chair.” 

On why it matters to end users 

The benefits of seat elevation are many, including less wear and tear on shoulders and increased independence, but what sticks in Rodriguez’s mind are “the little things.” 

“I was with a client in California a couple of years ago and they had a seat elevator, and we were crossing a street and that’s what allowed them to see across the hood of parked cars, so they could check both sides of the road and safely use the crosswalk,” he said. “It’s the little things, too. Until you live your life from their perspective, you don’t fully understand the impact.” 

On why other payers should follow suit 

Rodriguez believes Medicare Advantage plans will also cover seat elevation, but other payers will likely take more convincing. 

“Many commercial plans reiterate that they follow Medicare guidelines, but it’s going to take some conversation,” he said. “They’re probably not going to be as automatic as Medicare replacement plans, but we’re optimistic they will see the value.” 

On why this is just the beginning 

Rodriguez sees CMS’s landmark decision as a tipping point for the industry’s ability to make a case for coverage and payment for other new technology, including power standing. 

“There has been a lot of work within the CRT industry to get to this point,” he said. “While coverage was granted for seat elevation, Medicare chose not to make a similar decision for power standing, so yes we’re all very excited, but there’s more work to be done and greater advocacy needed to accelerate acceptance and coverage for new technology benefiting client outcome.”