![]() ![]() They lack full motor control and biomechanical access to their upper extremities and therefore cannot use the same equipment as all persons to reach items out of reach (ie: a stool). To qualify for a power wheelchair, a user must already have limitation in function and use of their upper extremities. Wheelchair users have access to the horizontal environment of their home, but, in the absence of power seat elevation, are denied access to the vertical environment of the home. Seat elevation has great medical necessity and safety value in the home, beyond transfers, and does not serve the same purpose as other equipment described in the iBot denial 2006. I also implore CMS to reconsider the concept of seat elevation as "serving the same purpose as other equipment that assist all persons in reaching items out of reach or having an eye-level" conversation with a standing person". I support the proposal of the medical necessity of power seat elevation for transfers as proposed by CMS. I can say with great confidence that power seat elevation greatly improves safety and independence for Activities of Daily Living in the home, directly in alignment with Medicare guidelines of medical necessity, supports a medical purpose, and compensates for a beneficiary's disability for independence, safety and home activities. I have prescribed power wheelchairs with power seat elevation to patients who have private paid, have received it through State Medicaid funding, or who have received it through VA benefits. I whole-heartedly support power seat elevation as an accessory to power wheelchairs. I have prescribed hundreds of wheelchairs in my 17 year career, most of which have been Group 3 power wheelchairs for individuals requiring full time power wheelchair use for all out of bed activity participation. I am the wheelchair Clinic Supervisor at Craig Hospital, working with patients with Brain Injury and Spinal Cord Injury. Please add this into the CMS proposal for seat elevators as a unique and separate condition for coverage. A seat elevator is absolutely necessary for those who need it for transfers, but it is equally necessary and likely used more by those who need it to complete MRADLs, especially for those with decreased overhead reach. These tasks can be really difficult to impossible to complete as a full-time wheelchair user, reducing independence and safety during tasks (think cooking on a stove top when you can't totally see what you're doing). ![]() This does not take into consideration that many power wheelchair users need the seat elevator to reach stove tops, counter tops, microwaves, sinks and refrigerator/freezer shelves to complete mobility-related activities of daily living like meal preparation, hygiene and eating. I see in that, under the current conditions of this update, seat elevation would only be approved when needed for transfers. I am hopeful that this change will take effect because it is a necessary change. It has regularly been a point of frustration for myself and my patients when they need a seat elevator but it is not available to them because of a lack of insurance coverage and the significant out-of-pocket expense. ![]() I am a PT who has completed wheelchair evaluations and prescriptions for a few years. I am excited to hear that CMS has proposed to include coverage of seat elevation for power wheelchair users. ![]()
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