Newly Expanded Medicare Benefit for Power Wheelchairs Celebrated by United Spinal Association

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May 17, 2023, 12:03 ET

KEW GARDENS, N.Y., May 17, 2023 /PRNewswire/ -- Late yesterday afternoon, the Centers for Medicare & Medicaid Services (CMS) issued a decision that expands the mobility device benefit and establishes power seat elevation for all power wheelchairs to be eligible for coverage by the Medicare program.

This newly expanded Medicare benefit will enable many more power wheelchair users to independently do more everyday tasks, like reach high cabinets.

"We are pleased the Centers for Medicare and Medicaid Services heard our members and acknowledged that people with mobility disabilities share the same desire to achieve, pursue and thrive as every other community," says Vincenzo Piscopo, President and CEO of United Spinal Association. "With this historic decision, CMS has made it easier for more wheelchair users to reach for the stars. We thank everyone who submitted comments, and especially the coalition of partners and stakeholders, including the ITEM Coalition, who worked with United Spinal on this critical issue."

This expanded Medicare benefit is effective immediately. Now people with mobility disabilities will be able to use power wheelchairs with seat elevation. This will enable them to reach higher and more easily handle mobility-related activities of daily living such as bathing, dressing, grooming, and preparing and eating meals.

This is a major coverage expansion from the preliminary coverage decision CMS announced in mid-February. CMS attributed these coverage improvements to the 2,100 public comments received by wheelchair users, advocates, clinicians, and researchers.

What This Life-Changing Expanded Benefit Covers

CMS acknowledges that power wheelchairs are primarily medical and durable medical equipment (DME) for both traditional Medicare and Medicare Advantage.

Seat elevation will now be covered:

When needed to transfer from one surface to another with or without caregiver assistance, assistive devices, or lift equipment or to improve one's reach to perform mobility-related activities of daily living (MRADLs);
In non-CRT power wheelchairs when determined by Medicare contractors to be reasonable and necessary.

To qualify for the expanded benefit, wheelchair users must undergo a specialty evaluation performed by a licensed/certified medical professional with specific training and experience in rehabilitative wheelchair evaluations.

United Spinal is delighted with this final decision from CMS as it is a huge win for all wheelchair users. We know what this means to United Spinal members and all members of the community living with Parkinson's disease, multiple sclerosis, cerebral palsy, spinal cord injury, paralysis, ALS, limb amputation, lupus, rheumatoid arthritis, myositis, and other mobility-related conditions.

SOURCE United Spinal Association