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.”