Medicare only considers the seat lift mechanism on a lift chair to be medically
necessary if all of the following coverage criteria are met:
- The patient must have severe arthritis of the hip or knee or have a
severe neuromuscular disease.
- The seat lift mechanism must be a part of the physician's course of
treatment and be prescribed to effect improvement, or arrest or retard
deterioration in the patient's condition.
- The patient must be completely incapable of standing up from a regular
armchair or any chair in their home. (The fact that a patient has difficulty
or is even incapable of getting up from a chair, particularly a low chair,
is not sufficient justification for a seat lift mechanism. Almost all
patients who are capable of ambulating can get out of an ordinary chair if
the seat height is appropriate and the chair has arms.)
- Once standing, the patient must have the ability to ambulate (walk).
Coverage of seat lift mechanisms is limited to those types which operate
smoothly, can be controlled by the patient, and effectively assist a patient in
standing up and sitting down without other assistance. Excluded from coverage is
the type of lift which operates by spring release mechanism with a sudden,
catapult-like motion and jolts the patient from a seated to a standing position.
Coverage is limited to the seat lift mechanism, even if it is incorporated into
a chair. Medicare reimbursement is approximately $275.00.