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Excellus BlueCross BlueShieldCommercial · Coverage · Home Care · NYMedium impact

Patient Lifts - (Effective Date - 2026-11-16) 1.01.08

Effective date
Nov 16, 2026
Identified
Sep 15, 2026

Summary

Excellus BlueCross BlueShield Patient Lifts policy 1.01.08 takes effect November 16, 2026. Patient lifts are medically appropriate durable medical equipment when periodic movement is necessary to improve, stop or delay deterioration, transfer between bed and chair, wheelchair or commode needs more than one person, the individual would otherwise be confined to bed, and a trained person other than the individual can operate the lift. Seat lift chair mechanisms are medically appropriate for severe arthritis of the hip or knee or severe neuromuscular disease, and the July 16, 2026 annual review clarified that these criteria must be met to be considered medically necessary.

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What to do

Action · 9 steps
01Starting November 16, 2026: Before billing a patient lift or seat lift mechanism, confirm the criteria in this policy are met.
02A motorized lift such as a Sara lift is appropriate only if a hydraulic lift such as a Hoyer lift is inadequate to meet the individual's special medical needs.
03A seat lift chair mechanism is medically appropriate only after all appropriate therapeutic modalities, such as medication and physical therapy, have been tried and failed, when the individual is completely incapable of standing up from a regular armchair or any chair in the home and is able to ambulate once standing.
04Repair of a medically necessary lift not under warranty requires physician documentation of the date of DME initiation, manufacturer warranty information if applicable, and an attestation that the individual has been compliant with the DME and will continue to benefit from it.
05Replacement of a properly functioning lift is considered not medically necessary.
06E0625 is marked not medically necessary.
07Bath lifts, ceiling lifts, platform lifts, stair gliders, stairway chair or stair lifts, powered wheelchair lifts and van lifts are ineligible for coverage.
08Repair or replacement of equipment damaged by neglect, theft or abuse, or when another coverage source such as homeowners, auto or liability insurance is an option, is ineligible for coverage.
09Codes may not be covered under all circumstances.

Codes mentioned

E0621E0625E0627E0629E0630E0635E0637

Original notice

Patient Lifts - (Effective Date - 2026-11-16) 1.01.08
excellusbcbs.com · Always check the source before changing claims.
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