Date: Wednesday, April 29, 2026
Category: Member News

Why are we fighting for power seat elevation AGAIN?

If you were confused about the recent flurry of news articles and advocacy about power seat elevation in wheelchairs, you weren’t the only one.

Medicare began covering power seat elevation for eligible wheelchair users nationwide starting May 16, 2023, when CMS officially issued a National Coverage Determination, or NCD. This was a huge win for wheelchair users and advocates.

Three years later, in February 2026, the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) issued two proposed Local Coverage Determinations (LCDs) for public comment that would effectively eliminate seat elevation in practice for non‑complex (Group 2) wheelchairs.  A hearing was held on March 25, 2026, to solicit feedback from stakeholders, including the ITEM Coalition, of which RESNA is a member. In addition, RESNA submitted comments to the DME MACs, along with the ITEM Coalition and NCART.

Coverage of seat elevation remains unchanged currently. However, if these two proposed LCDs are approved by the DME-MACs as they currently stand, wheelchair users who do not qualify for Group 3 wheelchairs will lose access to seat elevation.

How Do NCDs and LCDs Work Together?

Think of it as a chain of authority:

1. Medicare law
2. National Coverage Determinations (NCDs)
3. Local Coverage Determinations (LCDs)

NCDs set nationwide coverage rules, while LCDs may add local operational details, as long as they do not conflict with national policy. An LCD cannot be more restrictive or more generous than the national rule.

RESNA argued that while the NCD explicitly covers complex wheelchairs, the proposed LCDs are more restrictive than the intent of the national policy and the clinical evidence CMS relied upon, effectively eliminating access to seat elevation for non‑complex wheelchair users who may still have clear medical need.

There are many instances when a patient may not qualify for a Group 3 wheelchair but would still benefit from seat elevation. For example, older adults and patients with orthopedic and/or cardiovascular conditions (such as osteo and rheumatoid arthritis, congestive heart failure, COPD, etc.) could benefit from power seat elevation to perform sit-to-stand transfers safely, allowing these patients to stay in their homes and preventing falls.

Advocacy can’t stop when we achieve coverage; we must continue our advocacy to ensure access for those that can benefit from assistive technology. The recent activity surrounding power seat elevation is an excellent case study, showing that our work is never done.

See RESNA’s comment letters (link to website)

We will report back once the DME-MACs issue the final LCDs. Stay tuned!