Seat elevation: Stakeholders applaud CMS’s proposal

WASHINGTON – It’s a “pretty big milestone” for CMS to agree, in a recent proposed national coverage determination, that power seat elevation systems are “medical in nature,” says the ITEM Coalition’s Peter W. Thomas. 

CMS published the proposed NCD on Feb. 15, saying it planned to, for the first time, expand coverage for seat elevation on Group 3 wheelchairs for beneficiaries who perform weight-bearing transfers to/from their wheelchair in the home. 

“They determined that it was not a convenience or a luxury item to the Medicare beneficiary and that it’s primarily medical in nature,” said Thomas, managing partner at Powers Law Firm in Washington, D.C., and co-coordinator of the ITEM Coalition, which made the request to expand coverage in September 2020. “It’s a pretty big milestone.” 

CMS will accept comments on the proposed NCD until March 17 and then will publish a final NCD. 

Thomas acknowledges, however, that the proposed NCD is “relatively narrow,” and doesn’t expand coverage for reaching – an ability any wheelchair user needs, particularly those in Group 3s, to perform mobility related activities of daily living. 

“Reach is involved in dressing and grooming and bathing,” he said. “Because of the close link to MRADLs, we feel they should also extend coverage based on the ability to reach.” 

The Clinician Task Force’s Cara Masselink believes CMS should also expand coverage for line of sight – another ability closely linked to MRADLs. 

“When a Group 3 wheelchair user is in an environment for ambulatory people, they’re always looking up and hyperextending their neck, and reaching for items overheard and overusing their shoulders,” said Masselink, executive director of the Clinician Task Force. “CMS has produced many documents that say their coverage is based on the function of the wheelchair user and, as part of that, they should be looking at the ability to perform MRADLs.” 

While groups like the ITEM Coalition, the Clinician Task Force and NCART will address these intricacies in their comments, they encourage others to focus on stories and examples of how seat elevation can make a difference in a wheelchair user’s life, says NCART’s Wayne Grau. 

“During the initial comment period, there were more than 3,500 comments and one of the reasons we’ve gotten this far is because a lot of those comments were from the heart about why this is so important,” said Grau, executive director of NCART. “We need to make those voices heard again.” 

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