Academy of Neurologic Physical Therapy Podcast · Academy of Neurologic Physical Therapy

SWM SIG podcast: Dan Fedor – CRT legislation and funding updates -Episode 2

·28 min·1 clip

The criteria now include weight-bearing transfers, non-weight-bearing transfers, and reach for seat elevation.

1. Academy of Neurologic Physical Therapy’s Seating and Wheeled Mobility SIG podcast focuses on Dan Fedor’s legislative and funding updates for wheelchair seating and mobility. 2. Wendy Kesters hosts with Ashley Detterbeck as co-host, and Dan Fedor brings reimbursement, Medicare, and VGM Group experience from U.S. Rehab. 3. The episode asks what recent CMS changes mean for clinicians, suppliers, and patients trying to secure wheelchair technology. 4. Dan says U.S. Rehab, a division of the VGM Group, supports home medical equipment providers with reimbursement and legislative advocacy. 5. He says VGM has about 4,000 members nationwide, including about 400 in rehab and mobility. 6. The first policy change Dan highlights is CMS’s October 1 notice removing the ICD-10 requirement for skin protection and positioning cushions and backs. 7. Dan says the condition still must be documented, but the patient no longer needs a specific diagnosis code from a published list. 8. Ashley says the change matters for patients with dementia and Alzheimer’s disease who clearly need skin protection but lacked the qualifying code. 9. Dan explains that a patient could qualify for a tilt system by inability to perform a functional weight shift even when the old ICD-10 rule blocked cushion coverage. 10. He says the new rule makes that funding pathway more logical and reduces a contradiction in Medicare policy. 11. The second major update is Medicare’s May 2023 approval of power seat elevation. 12. Dan says seat elevation had been non-covered for as long as he can remember before becoming a covered category. 13. He says the draft criteria were initially narrower and then expanded after more than 3,000 comments from clinicians, suppliers, patients, and advocacy groups. 14. The final criteria include weight-bearing transfers, non-weight-bearing transfers, and reach. 15. Ashley says manufacturers have stepped up with more options in group 2 and group 3 power chairs. 16. Dan says VGM is hosting a webinar on November 14 called “don’t be afraid to provide seat elevation” because use has not matched expectations since coverage began. 17. Ashley says a seat elevation and standing project started together in 2020 and later split apart by CMS. 18. Dan and Ashley say a recent August meeting with CMS on power standing was promising, and they expect possible movement in 2026. 19. The conversation stays practical and clinician-facing, with Dan, Wendy, and Ashley trading examples from documentation, appeals, and funding barriers. 20. Clinicians, rehab suppliers, and wheelchair seating specialists will get the most value, while listeners seeking a non-technical mobility policy discussion may skip it.

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