Power seat elevation: Stakeholders warn against rolling back coverage
By Liz Beaulieu, Editor
Updated 9:21 AM CDT, Fri April 17, 2026
WASHINGTON – Leaders of the ITEM Coalition and NCART gave oral testimony during an open meeting on March 25 strongly opposing a proposal to reverse course and deny coverage for power seat elevation for certain Group 2 non-complex power wheelchairs (K0830 & K0831).
The Centers for Medicare and Medicaid Services (CMS) in February issued a proposed local coverage determination (LCD) for a not reasonable and necessary determination for power seat elevation for these wheelchairs based on their assessment of the available evidence. Previously, in a national coverage decision (NCD) in May 2023, the agency approved coverage on all Medicare-covered power wheelchairs i.e., Groups 2, 3 and 5.
“The 2023 decision and NCD was based on extensive review of all the clinical literature they could find, and this is not an insignificant process,” said Peter Thomas, who coordinates policy for the ITEM Coalition. “It was a major review, and they came out with an expansive policy. It was rejoiced. We commended CMS.”
Also giving oral testimony: Julie Piriano, senior director of payer relations and regulatory affairs for NCART.
Discretion versus ‘blanket non-coverage’
In the NCD, CMS left coverage for seat elevation on Group 2 non-complex power wheelchairs to the discretion of the DME MACs “on a case-by-case basis.” Now, in the proposed LCD, the DME MACs are proposing “blanket non-coverage,” Thomas says.
In his testimony, he argued that CMS needs to not only drop the proposed LCD but also issue an affirmative coverage policy for power seat elevation for Group 2 non-complex power wheelchairs.
“We’re no longer comfortable with a case-by-case determination,” he said. “As long as the prescriber documents medical necessity and need for seat elevation, that’s it. That should be the coverage policy.”
Bad signaling to beneficiaries and clinicians
If CMS and DME MACs move forward with denying coverage for power seat elevation for certain Group 2 non-complex power wheelchairs (K0830 & K0831), it will be a major hit to what was “a landmark decision,” Thomas says.
Under the NCD issued in May 2023, Medicare beneficiaries with multiple sclerosis, lower limb amputees and other conditions had access to the technology to help them complete mobility-related activities of daily living like transitioning from their bed to their wheelchair and using a microwave to prepare their meals.
“It really sends a signal to this population and the clinical community that they can’t rely on consistent coverage,” Thomas said. “That’s not a good way to run a health care program.”
A looming access cliff?
The decision to reverse course would also have repercussions for beneficiaries who have been able to access power seat elevation under the final NCD in 2023, Thomas says.
“At the five-year reasonable useful lifetime of the wheelchair, when they need a new wheelchair, they may no longer be eligible for power seat elevation, and they’ll have to do without,” he said. “And at that point, they’ve gotten used to using it.”
Comment period and next steps
CMS accepted comments on the proposed LCD through April 4. The agency will then make a final decision within 365 days.
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