F2F is REQUIRED and documentation must be provided to supplier

The physician ordering the seat lift mechanism must be the treating physician or a consulting physician for the disease or condition resulting in the need for a seat lift. The physician’s record must document that all appropriate therapeutic modalities (e.g., medication, physical therapy) have been tried and failed to enable the beneficiary to transfer from a chair to a standing position.

Valid Physician Order/Statement of Medical Necessity that contains:

- Beneficiary’s name

- Physician’s name

- Date of the order and the start date, if start date is different from the date of the order

- *Detailed description of the item – seat lift mechanism incorporated into a combination lift-chair mechanism; separate seat lift mechanism for use with patient owned furniture-electric; separate seat lift mechanism for use with patient owned furniture-non-electric

- Treating physician’s signature, NPI, and signature.

These items require an in-person or F2F interaction between the beneficiary and their treating physician prior to prescribing the item, specifically to document that the beneficiary was evaluated and/or treated for a condition that supports the need for the item(s) of DME ordered.

A dispensing order is NOT sufficient to provide these items.

Allowable for a lift chair is $274 – 244 (Wa or Id residency rural or non rural) if beneficiary meets ALL of the following criteria:

- Beneficiary has 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 beneficiary’s condition

Beneficiary must be completely incapable of

standing up from a regular armchair or any chair in their home. (The fact that a beneficiary has difficulty

or is even incapable of getting up from a chair, particularly a low chair, is

not sufficient justification for seat lift mechanism. Almost all beneficiaries 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 beneficiary must have the ability to ambulate.