Medicare Moves to Significantly Expand Access for Seat Elevation Systems in Power Wheelchairs

Members & Publications


May 17, 2023

The Centers for Medicare and Medicaid Services (CMS) published a National Coverage Decision (NCD) on May 16, 2023, dramatically expanding coverage of seat elevation systems in power wheelchairs for Medicare beneficiaries. This advancement comes after many years of advocacy from AAPM&R and our members who treat patients that rely on seat elevation systems to perform daily activities.

The final NCD issued by CMS dramatically expands coverage for seat elevation in all Complex Rehabilitation Technology (CRT) power wheelchairs. This expanded coverage applies to all Medicare beneficiaries who need seat elevation for assistance in transfers and to improve their reach while performing or participating in mobility related activities of daily living (MRADLs), such as grooming, dressing, and bathing in the home.

“The decision by CMS to recognize power seat elevation systems as primarily medical in nature, expanding access for Medicare beneficiaries, is a significant step forward for patients that require access to these systems in order to live independent lives,” according to Anjali Shah, MD, FAAPMR, a member of AAPM&R’s Health Policy & Legislation Committee and Director of Wheelchair and Seating at UT Southwestern Medical Center. “Expanding access to these systems will promote safety, reduce medical comorbidities, provide privacy and integrity for the most basic human tasks, and open the door for many of the patients that I treat to achieve independence.”

The release of this groundbreaking NCD follows CMS determining in February 2023 that the need for seat elevation systems is “primarily medical in nature,” and proposing that Medicare should cover these systems for Group 3 CRT power wheelchair users. AAPM&R submitted comments in support of this first step, and asked CMS to go beyond the initial proposal to expand access for Group 2 CRT power wheelchair users and patients who would benefit from increased reach and improved line of sight provided through seat elevation. CMS received overwhelming support for this initial proposal, with more than 2,100 comments submitted before the comment period closed.

AAPM&R has also collaborated with other stakeholders to advocate for expanded coverage for seat elevation systems for power wheelchair users under the Medicare program. AAPM&R is a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, a consumer and clinician-led coalition of more than 75 national organizations advocating for access to and coverage of assistive devices, technologies, and related services for persons with injuries, illnesses, disabilities, and chronic conditions of all ages. AAPM&R assisted with the ITEM Coalition’s comments to CMS on the initial proposal to expand coverage.

This NCD represents a significant step forward in expanding equity and access to critically important medical technology for Medicare beneficiaries and will improve the quality of life for many patients that rely on power wheelchairs. AAPM&R thanks CMS for taking this step forward and will continue to press for further progress through our advocacy efforts for patients who require standing systems or assistance with line of sight.

Read more in this article from our July 2023 issue of The Physiatrist:  "Expanded Coverage for Power Seat Elevation Systems—A “Win” for AAPM&R and the Specialty."

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.