Bariatric Funding: A Seating Challenge?

While Medicare funding rates in general aren’t where complex rehab providers would like them to be, the niche of bariatric seating & mobility contains a diff erent sort of kink.

Jay Brislin, MSPT, VP of Quantum Rehab, points out that current Medicare policy does separate bariatric power mobility bases — known as “heavy-duty” and “very heavy-duty” types, in Medicare terms — from standard-sized bases.

“The issue that comes into play is that there is no coding for bariatric seating,” Brislin says. “So you might have a higher allowable for the base, which you need, because there’s a big difference between a base being able to accept 300 lbs. versus 450 lbs. versus 600 lbs., and what needs to go into the design and development of that. But there are no bariatric seating codes.”

Brislin contends that just as bariatric-sized power mobility bases require specialized engineering and extra or upgraded materials to handle high weight capacities, so do seating systems. That includes not just the seat components themselves, but also positioning components, including headrests, footrests and armrests.

Making all funding sources aware of the additional costs incurred in designing and manufacturing bariatric seating components remains an industry challenge, Brislin says.

“There should also be codes with higher allowables for bariatric seating, because those seating components, even if it’s just a standard van seat, need a lot more material and need to be a lot more heavy duty to carry that weight properly than a system for somebody 300 lbs. or less,” he says.

Higher allowables would also more accurately reimburse providers for the specialized attention that these patients need, Brislin adds.

“The allowables for these products is very low, and the amount of time you need to spend with a bariatric client is very high.”

This article originally appeared in the May 2012 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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