VGM & ASSOCIATESHealthcare MSO
Full Menu Search

Proposed LCD Changes to Impact Seat Elevation on Group 2 Non-Complex Power Wheelchair Bases

Published in Government Relations on February 23, 2026

The DME Medicare Administrative Contractors (MACs) issued a proposed Local Coverage Determination (LCD) change for seat elevation use on group 2 non-complex power wheelchair bases (K0830, K0831 and K0108 on group 2 non-complex HD bases). 

They are proposing to change the policy for these to be not reasonable and necessary which would eliminate the current policy of "at the MACs discretion.” Since seat elevation was changed from non-covered to covered on May 16, 2023, seat elevation has been covered and benefitted those patients who qualify for complex as well as non-complex power wheelchairs. This proposed change does NOT impact seat elevation on K0835-K0864 power wheelchair bases as these are considered complex.  

The MACS are hosting a virtual meeting on Wednesday, March 25 from 9 – 11 a.m. CST to discuss the proposed LCD changes, and the public comment period is open through Saturday, April 4.  

Register Here

Issue Description - PMD LCD 

The proposed LCD proposes a not reasonable and necessary determination for Group 2 power wheelchairs (PWCs) with seat elevation systems (K0830 and K0831), based on the best available evidence. Per the National Coverage Determination (NCD) 280.16 Seat Elevation Equipment (Power Operated) on Power Wheelchairs, coverage of Group 2 PWCs with seat elevators would be determined at the MAC’s discretion. 

Issue Description - Wheelchair Options LCD  

The proposed LCD proposes a not reasonable and necessary determination for the use of seat elevation added onto non-complex power wheelchairs, based on the best available evidence. The proposed LCD proposes to include, in the coverage criteria for power tilt and/or recline seating systems, examples of clinical conditions that limit the beneficiary’s ability to perform a functional weight shift. Per National Coverage Determination (NCD) 280.16 Seat Elevation Equipment (Power Operated) on Power Wheelchairs, coverage of power seat elevation equipment for individuals who use Medicare-covered power wheelchairs other than complex rehabilitative power-driven wheelchairs would be determined at the MAC’s discretion. 

MACs Article

Get Connected

Stay up-to-date on the latest resources and news provided by VGM & Associates.

Sign Up for Email

From Our Experts

CMS Makes Finalized Change to DMEPOS Competitive Bidding Program thumbnail CMS Makes Finalized Change to DMEPOS Competitive Bidding Program The Centers for Medicare and Medicaid Services (CMS) has issued the FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F), increasing the DMEPOS Competitive Bidding Program's bid surety bond amount to $100,000 (previously $50,000).... VGM Government Relations Launches State Payer Resource Hub for DMEPOS Providers thumbnail VGM Government Relations Launches State Payer Resource Hub for DMEPOS Providers This resource brings together key information frequently used by DMEPOS providers. Kentucky Governor Announces Reprieve from Previously Announced Kentucky Medicaid 4% Rate Cut thumbnail Kentucky Governor Announces Reprieve from Previously Announced Kentucky Medicaid 4% Rate Cut The administration expects the surplus funding to sustain current reimbursement levels through June 2027. NAAOP and OPGA Co-Host Second Annual In-Person Legislative Fly-In thumbnail NAAOP and OPGA Co-Host Second Annual In-Person Legislative Fly-In Last week, over 30 stakeholders, advocates, and leaders from around the O&P profession convened at the offices of Powers Pyles Sutter & Verville PC in Washington, D.C., as part of the National Association for the Advancement of Orthotics and Prosthetics' (NAAOP) second annual in-person legislative fly-in. Round 2028 Updates for Competitive Bidding & Interoperability Rule FAQ thumbnail Round 2028 Updates for Competitive Bidding & Interoperability Rule FAQ On Nov. 28, 2025, the Centers for Medicare & Medicaid Services (CMS) announced plans for Round 2028 of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). If you plan to bid, the time to prepare is now... What DMEPOS Providers Need to Know About H.R. 3514: Improving Seniors' Timely Access to Care Act thumbnail What DMEPOS Providers Need to Know About H.R. 3514: Improving Seniors' Timely Access to Care Act Medicare Advantage prior authorization continues to be one of the most significant operational and patient care challenges facing DMEPOS suppliers. A new bipartisan bill, H.R. 3514: Improving Seniors' Timely Access to Care Act, seeks to increase transparency, accountability, and oversight of Medicare Advantage prior authorization practices. This bill passed out of Ways & Means markup by a unanimous vote (42-0) on July 15... H.R. 1703 Advances, Bringing Greater Choice for Wheelchair Users thumbnail H.R. 1703 Advances, Bringing Greater Choice for Wheelchair Users The DMEPOS community, particularly wheelchair providers and users, should be celebrating an important victory as the House approved the Choices for Increased Mobility Act (H.R. 1703). North Carolina Medicaid Rate Floor Extended Through 2029 thumbnail North Carolina Medicaid Rate Floor Extended Through 2029 Earlier this year, it was announced that the North Carolina General Assembly has approved the state budget, securing an additional full two-year extension of the Medicaid fee schedule floor. This protection will now remain in effect until June 30, 2029, guaranteeing that reimbursement rates will continue to be set at 100% of the lesser of the supplier's usual and customary rate or the maximum allowable Medicaid fee-for-service rate.

Give your business an advantage over the competition.

Become a Member