Seat elevation equipment for power wheelchairs is now a covered expense under Medicare.

The Centers for Medicare and Medicaid Services (CMS) announced last week it will now classify power seat elevation systems as “reasonable and necessary” equipment for people who need to be able to get in and out of a wheelchair while in their home. A physical therapist or other trained professional must evaluate the person’s ability to operate the equipment before the expense is approved.

The announcement reverses a 2006 CMS finding which concluded seat elevation systems were fundamentally similar to devices used by non-wheelchair users, and thus not eligible for classification as medical equipment. 

The Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition asked CMS in 2020 to re-examine the issue. CMS began a review of the proposed change in August 2022. 

In its decision summary, CMS said nearly half of all wheelchair users experience shoulder pain. Studies cited by CMS suggest one cause of that pain is the effort required to physically lift oneself out of the chair to a bed, bathtub, or toilet, and back again. CMS also noted wheelchair transfers are a common cause of falls among users. 

The coverage change took effect May 16, the day of CMS’ announcement.

The U.S. Census Bureau says 5.5 million American adults use a wheelchair.