Tomorrow's Power Chairs

Funding Update: Power Seat Elevation

When it comes to funding for power seat elevation, Medicare’s lack of response leaves most in the industry scratching their heads.

“I don’t understand it,” says Brad Peterson, of Motion Concepts. “Medicare said that they pay for functional ability in the home. I don’t know about you, but if I came home tomorrow in a wheelchair, I couldn’t access most things in my home without being able to raise my seat. It’s something that should be looked at, should be more readily available.”

Amy Morgan, PT, ATP, at Permobil, says that even though progress is not being made with Medicare, there is some hope at the state level.

“State Medicaid funding for seat elevation is improving, obviously dependent upon the state,” she says. “The states that have been challenged as to why they’re denying seat elevation have seen success and have seen policies changed and now cover seat elevation.”

In some instances, Morgan has seen this strategy work with Medicare on an individual basis, after fighting through the appeals process.

“There have been individuals who have been successful in getting seat elevation authorized through Medicare, but it’s an individual thing,” she emphasizes. “They’re (Medicare) not changing their policy anytime soon.”

Jay Doherty, OTR, ATP/SMS, at Quantum Rehab, is hoping the passage of the separate benefit category for complex rehab technology will lead to more funding for power seat elevation.

“One of the problems we face right now is that durable medical equipment and complex rehab technology are still lumped into the same category in Medicare, which really makes it difficult for coding, coverage and payment policies to be written in a manner that accurately meets the needs of the smaller groups within the larger group,” he says. “And the complex rehab technology really has its own niche. It really meets a need of a specific part of the population.”

In the meantime, Doherty encourages clinicians to continue prescribing power seat elevation. In fact, he says clinicians have an “obligation” to do so and to tell clients how they will benefit from the technology.

“Without the continual recommendation of that type of system, we can’t document the benefit of the device itself,” he says.

The National Registry of Rehabilitation Technology Suppliers (NRRTS) and the University of Pittsburgh are currently working on a study that Doherty says is showing that many individuals cannot reach surface heights and carry out daily tasks using their current mobility devices without seat elevation. He hopes this type of evidence will fuel the fight for coverage.

Meanwhile, the industry laments the lack of funding that ultimately dampens the development and implementation of new technologies — not only for seat elevation but also across the board.

“There are still many, many, many things that we can do,” Peterson says. “We can give people access to different parts of their environment, but also give them the ability to use their chair to do more. But it all comes down to funding.”

For Dan Critchfield, at Sunrise Medical, the consumer is the key to improving funding. Just as they’ve demanded technological improvements in equipment, clients must also demand coverage.

“I think that consumer advocacy is now the best opportunity to get seat elevators funded,” he says. “As consumers continue to become more involved in the efforts to improve their access to this technology — and complex rehab technology as a whole — I believe funding sources will follow.”

To find out if your state covers power seat elevation, visit medicaid.gov, click on the menu Medicaid and choose By State.

This article originally appeared in the August 2013 issue of Mobility Management.

About the Author

Elisha Bury is the editor of Respiratory Management.

Subscribe to eMobility

Mobility Management's free email newsletter keeping you up-to-date and informed.

I agree to this site's Privacy Policy