Seat elevation: Stakeholders ask CMS to take another look

WASHINGTON – NCART is using the Medicare Electronic Application Request Information System (MEARIS) as a tool to secure another meeting with CMS officials to discuss lower-than-expected reimbursement for power seat elevation systems. 

The organization submitted an application through the system in July, shortly after CMS announced that it would increase the reimbursement for these systems but only by $13.62 to $2,013.96. 

“We talked to our members, and they asked us, ‘Is there anything else we can do,’” said Wayne Grau, executive director of NCART. “So, (Julie Piriano, senior director of payer relations & regulatory affairs for NCART,) submitted an application for a redetermination through the MEARIS system, which will allow us to meet with the overall coding committee, so they can make a decision.” 

In March, CMS established a new code, E2298, for seat elevation systems and set reimbursement to about $2,000 effective April 1, a steep decrease compared to the $2,800 it had been paying on interim basis prior to that. 

In the next meeting with CMS, which Grau doesn’t expect to happen until later in the year, stakeholders plan to, again, point out to the agency the unfairness of including Internet pricing for seat elevation systems in its calculations for reimbursement, Grau says. 

“When we’re dealing with complex rehab, there are so many requirements, including working with a therapist and trying out multiple products to make sure it’s effective and meets goals,” he said. “None of that is done with an Internet company. Luckily, there are not a tremendous amount of Internet companies offering this product, but there are enough that CMS is including that pricing in their evaluation.” 

Grau still believes that reimbursement for seat elevation systems is “too important not to get right – and CMS wants to get it right, too.” 

“CMS has been good to work with on this,” he said. “All we can ask is for them to listen to our concerns. We don’t want to leave any stone unturned.”  

• Read about the ITEM Coalition’s several years long effort to secure coverage for seat elevation systems.