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CommercialCoverageMedium impact

Patient Lifts (e.g., Hoyer, Saralift, Seat Lift, Chair Mechanisms, and Ceiling Lifts) 1.01.08

Excellus BlueCross BlueShield·PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy +4 more·Home Care
Effective date
Jul 17, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Excellus BlueCross BlueShield has established comprehensive coverage criteria for patient lifts and seat lift mechanisms as durable medical equipment, including specific requirements for coverage, repair, and replacement. The policy excludes certain types of lifts like ceiling lifts and bathroom lifts from coverage.

Action Required

Action needed
By July 17, 2025: Billing team must update prior authorization requirements for patient lift equipment (HCPCS codes E0621, E0627, E0629, E0630, E0635, E0637) to ensure all coverage criteria are documented before billing. Mark E0625 as non-covered for bathroom/toilet lifts. Update encounter forms to remind providers of specific medical necessity requirements including multi-person transfer needs and availability of trained operators.

Affected Billing Codes

E0621
E0625
E0627
E0629
E0630
E0635
E0637