Being an advocate for Complex Rehab Technology (CRT) can be as simple as sending an email to your Legislators making them aware of the challenges to appropriate access for people with disabilities and asking them for their support. The more voices delivering our CRT message the better!
Without your help, Congress will not fully understand how CRT maximizes independence and protects the health of the individuals who depend on it. Review the current CRT issues below and use the links provided to contact your Members of Congress today to protect access!
Medicare Coverage of Power Seat Elevation and Standing Systems
Medicare currently DOES NOT cover power seat elevation and power standing systems used with CRT power wheelchairs. Clinical evidence shows these CRT systems provide significant medical benefits to people with disabilities and enable them to be much more independent in their homes and communities.
In September 2020, the ITEM Coalition (a coalition of patients, providers, researchers, and other subject matter experts including NCART) submitted a formal Request for Reconsideration of the existing National Coverage Determination (NCD) for Mobility Assistive Equipment to advance a coverage policy for these systems under the Medicare DME benefit. In August 2022, nearly two years after the initial request was submitted, CMS opened the public comment period for power seat elevation systems, but unexpectedly and without explanation did not open the related review of power standing systems.
On February 15, 2023, CMS officially shared its proposed coverage determination for power seat elevation systems (read the full decision memo here).
The agency determined that power seat elevation systems are reasonable and necessary for individuals using Group 3 power wheelchairs when all of the following conditions are met:
- The individual performs weight-bearing transfers to/from the power wheelchair while in the home, using either their upper extremities during a non-level (uneven) sitting transfer and/or their lower extremities during a sit-to-stand transfer. Transfers may be accomplished with or without caregiver assistance and/or the use of assistive equipment (e.g. sliding board, cane, crutch, walker); and,
- The individual has undergone a specialty evaluation by a practitioner who has specific training and experience in rehabilitation wheelchair evaluations, such as a physical therapist (PT) or occupational therapist (OT), that assesses the individual’s ability to safely use the seat elevation equipment in the home.
CMS will now be accepting public comments regarding the proposed coverage until March 17, 2023. The dedicated website at www.rise4access.org has been updated with suggested talking points and instructions on how to submit your comments.
Once those comments are reviewed, CMS will issue a final coverage determination. We will continue to provide updates on this and our efforts to secure coverage for Power Standing systems as they become available.
Additional Resources: