How to File the Forms for the Power Lift Chair Through Medicare

Power lift chairs offer increased independence and mobility for people with knee and hip problems or neuromuscular disease who are unable to stand up from a normal chair without assistance. The seats on power lift chairs move up and forward, offering support until the person is standing. Medicare does cover these chairs for certain conditions, as long as the patient meets the criteria and files the correct paperwork.

Instructions

1. Check the criteria for lift chair reimbursement. Medicare requires that a patient have been diagnosed with either severe arthritis in the knee or hip or severe neuromuscular disease to qualify for a chair. Further, a doctor must prescribe the seat to either improve one of these conditions or to prevent further deterioration. The patient must be completely unable to get out of a normal chair without assistance and must be able to move around unassisted once they get out of the power chair. Each of these conditions must be met before Medicare will reimburse for a lift chair.

2. Obtain Medicare form CMS-849 from the Medicare website (see Resources). This form is the Certificate of Medical Necessity for Seat Life Mechanisms. The power lift chair company you are purchasing the chair from may also be able to provide you with the form.

3. Complete Section A. It requests the patient name, address, phone number and health insurance claim (HIC) number and the name, address, phone number and National Plan Identification (NPI) number of the prescribing physician and the supplier. The Health Common Procedure Coding System (HCPCS) codes for the particular type of lift chair being covered is also required (see Resources or ask the chair supplier). The location the chair will be used, such as the patient’s home or at a nursing home, should also be included.

4. Get your doctor to complete Section B. The prescribing physician or representative of the physician must complete this part of the form, which has a series of questions about the patient’s condition to determine eligibility. The length of time for which the physician thinks the patient will need the chair and the diagnostic codes for the patient’s condition must also be included in this section.

5. Ask the chair supplier to complete Section C. They must describe the kind of power lift chair being ordered as well as any accessories required to make the chair functional.

6. Have the physician sign Section D. After reviewing all of the information, the prescribing physician must sign this section attesting that all of the information is correct to the best of their knowledge.

7. Request that the supplier of the chair or the physician file Medicare form on your behalf. Medicare prefers to receive forms from one of these parties rather than the patient. You should only attempt to file the form yourself if both the supplier or the physician refuse or if they are not filing the form in a timely manner. If you need to self-file, you should first call (800) Medicare for instructions on the proper place to send your form based on your specific circumstances and any supplemental information they may need from you.

Tips & Warnings

• Your power lift chair supplier may be willing to handle the entire filing process on your behalf, including consulting with your prescribing physician for the required information and signatures.

References

• PHC: Medicare Coverage for Lift Chair
• Medicare.gov
• PHC: Medicare FAQ

Resources

• Medicare Form CMS-849
• FindaCode--Medical Billing Codes