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Patient Lifts (e.g., Hoyer, Saralift, Seat Lift, Chair Mechanisms, and Ceiling Lifts) 1.01.08
Effective date
Jul 17, 2025
Identified
Sep 15, 2026
Summary
Excellus BlueCross BlueShield issued a new Patient Lifts policy (1.01.08) effective July 17, 2025, establishing comprehensive coverage criteria for patient lifts, seat lift mechanisms, and related DME. The policy explicitly excludes bathroom lifts, ceiling lifts, platform lifts, stair lifts, and powered wheelchair lifts from coverage. Billing teams must immediately update claim submission rules to deny claims for excluded device types and implement documentation requirements for all lift-related authorizations.
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What to do
Action · 8 steps
01Immediately upon notice.
02Billing team must update billing system to deny claims for HCPCS codes E0625 (bathroom/toilet lifts), and flag for manual review any claims for ceiling lifts, platform lifts, stair lifts, stairway chairs, powered wheelchair lifts, and van lifts—these are NOT covered under this policy.
03Update claim submission protocols to require physician documentation for ALL approved lift claims (E0621, E0627, E0629, E0630, E0635, E0637) including: date of DME initiation, warranty information, patient compliance attestation, and confirmation that transfer requires 2+ persons OR patient would be confined to bed without the lift.
04For seat lift mechanisms (E0627, E0629, E0637), implement requirement that providers document EITHER severe hip/knee arthritis OR all four criteria for neuromuscular disease (failed conservative treatment, inability to stand from chair, ability to ambulate once standing).
05Create prior authorization workflow requiring these elements before claim submission to prevent denials.
06For repair/replacement claims, require physician attestation that equipment is no longer functioning adequately and repair cost does not exceed replacement cost.
07Failure to obtain required documentation will result in claim denials.
08This policy supersedes any prior guidance on patient lifts for Excellus members.
Codes mentioned
E0621E0625E0627E0629E0630E0635E0637
Original notice
Patient Lifts (e.g., Hoyer, Saralift, Seat Lift, Chair Mechanisms, and Ceiling Lifts) 1.01.08
excellusbcbs.com · Always check the source before changing claims.
Related changes
See all Excellus BlueCross BlueShield changes →Patient Lifts - (Effective Date - 2026-11-16) 1.01.08MediumEffective Nov 16, 2026 · Home CarePatient Lifts (e.g., Hoyer, Saralift, Seat Lift, Chair Mechanisms, and Ceiling Lifts) 1.01.08MediumEffective Jul 17, 2025 · Home CareStanding Devices and Gait Trainers 1.01.46MediumEffective Feb 19, 2026 · Durable Medical Equipment & SuppliesBrowse every Excellus BlueCross BlueShield change in the policy list