Skip To: Main content|Subnavigation|
Minnesota Department of Human Services Provider Manual
Advanced Search|  

Transfer and Mobility Device (TRAM)

Date: 07-05-2017

  • Overview
  • Eligible Providers
  • Eligible Recipients
  • Covered Services
  • Requests for use as a Gait Trainer
  • Requests for use for Seated Transfer
  • Requests for use for Sit-to-Stand Transfer/Passive Standing
  • Options and Accessories
  • Authorization
  • Billing
  • Overview

    The TRAM is used to ambulate, lift or transfer a patient. The gait training function of the device allows for safe ambulation. The sit-to-stand function permits a person to move from a seated position to a standing position. The sit-to-stand function also allows for passive standing. The seated transfer function is used to transfer a person from one surface to another.

    Eligible Providers

    Durable medical equipment vendors must be enrolled as Minnesota Health Care Programs (MHCP) medical equipment providers. Providers must be able to provide support services such as:

  • • Delivery and setup
  • • Repairs
  • • Warranty service (a copy of the warranty must be given to the recipient and a copy kept in the provider’s records)
  • • Education and ongoing assistance with the use of the TRAM
  • Providers must have skilled and knowledgeable service personnel to provide timely service and repairs.

    TPL and Medicare
    Providers must meet any provider criteria, including accreditation, for third party insurance or for Medicare in order to assist recipients for whom MHCP is not the primary payer.

    MHCP quantity limits and thresholds apply to all recipients unless only Medicare co-insurance or deductible is requested.

    Eligible Recipients

    The TRAM is covered for eligible MHCP recipients who meet the coverage criteria.

    Covered Services

    Code: E1399 NU Transfer and Mobility Device (TRAM), example includes the Rifton TRAM.

    Coverage Criteria
    Documentation must establish one of the following situations:

  • 1) Patient requires equipment for two or more TRAM functions, and does not currently have functional equipment. For example, patient requires a gait trainer and seated transfer (lift).
  • 2) Patient requires only one TRAM function and the TRAM represents the least costly, medically appropriate way to meet the patient’s medical needs.
  • Requests for Use as a Gait Trainer
    Recipient must meet MHCP criteria for a gait trainer (refer to Ambulatory Assist Equipment), including documentation of the following:

  • • Recipient’s age, height, weight and current level of mobility
  • • A physical therapy evaluation with baseline measurements, functional goals and recommendations for an assistive device to support gait training and ambulation, as well as any history of gait training and devices used
  • • Body weight support is required
  • • A specific therapy program detailing the frequency and duration of sessions during which the recipient will use the device
  • • The recipient cannot be safely and effectively transferred into a less costly gait trainer using other equipment
  • • Documentation of satisfactory caretaker use of the TRAM
  • The TRAM is documented as fitting in all necessary parts of the recipient’s home with a description of how it will be used in critical areas of the residence
  • • Less costly alternatives considered and why they were rejected (include specific product information)
  • Requests for Use for Seated Transfer
    Recipient must meet MHCP criteria for a transfer device, including documentation of the following:

  • • Recipient weight and height
  • • The recipient requires help from another person to transfer between a wheelchair, bed, commode or other surfaces in the home
  • • Description of the current method of transfer and why it does not meet the recipient’s needs
  • • Documentation that a medical condition requires a seated transfer must include one or more of the following:
  • • Body weight support is required
  • • Transfer device in an upright sitting position is required due to respiratory complications
  • • The recipient cannot be safely and effectively transferred using other equipment
  • • The plan of care
  • • Documentation of satisfactory caretaker use of the TRAM
  • The TRAM is documented as fitting in all necessary parts of the recipient’s home with a description of how it will be used in critical areas of the residence
  • • Less costly alternatives considered and why they were rejected (include specific product information)
  • Requests for Use for Sit-to-Stand Transfer and Passive Standing
    Recipient must meet MHCP criteria for a Stander (refer to Standers), including documentation of the following:

  • • Have little or no potential for walking
  • • Cannot stand unassisted for appreciable amounts of time
  • • Justification for body weight support and weight bearing
  • • A diagnosis of an underlying medical condition that involves inability to walk or loss of walking ability
  • • The stander must be an integral part of a therapy program in the home with specific, measurable outcomes unique to the recipient
  • • Satisfactory caretaker use of the TRAM
  • The TRAM is documented as fitting in all necessary parts of the recipient’s home with a description of how it will be used in critical areas of the residence
  • • Less costly alternatives considered and why they were rejected (include specific product information)
  • Options and Accessories
    The following items are included with the TRAM:

  • • Base frame
  • • One battery
  • • Thigh straps (pair)
  • • Charger power cord
  • • One battery charger
  • Include a list of all additional accessories not included with the TRAM with documentation of medical necessity for each item added to the device.

    Options and accessories for the TRAM may include:

  • • Low-base option
  • • Forearm supports
  • • Arm platforms
  • • Walking saddle
  • • Swivel locks
  • • Removable black belt
  • Authorization

    Authorization is always required. Follow these guidelines:

  • • If the recipient is currently in a nursing facility, the medical review agent will consider authorization if requested as part of a discharge plan. All other criteria must be met.
  • • Authorization requests for recipients under 21 years old must describe how the requested device will accommodate expected growth.
  • • Authorization requests for recipients with progressive diseases or conditions must include:
  • • An assessment of the effects of the disease’s progress on the recipient’s ability to use the requested device
  • • An estimate of how long the requested device is expected to meet the recipient’s needs
  • • Submit a log or documentation of a home trial with the authorization request.
  • • All authorization requests must include an assessment by a physical therapist. The assessment must include:
  • • The current program, functional goals and baseline for each goal
  • • Functional mobility status, including the amount of assistance required for sitting, standing, ambulation and transfers
  • Authorization is required for non-mobility equipment repairs or replacements if the submitted charge for any line using modifier RB or RA is over $400.

    Submit authorization requests with required documentation to the authorization medical review agent.

    Billing

    Approved Purchase
    Follow these billing guidelines for approved purchases:

  • • Use MN–ITS 837P Professional
  • • Submit a claim for the TRAM; make sure the HCPCS code, modifiers and the description on the claim match the same information on the prior authorization
  • • Enter the authorization number in the authorization field on the claim information tab of MN–ITS
  • • The approved rate will include all approved accessories
  • Accessories for Previously Purchased Standers
    If billing for accessories under $400, bill using the A9999, and NU modifier. Attach the manufacturer’s invoice, a price list or a quote from the manufacturer dated within three months. Clearly indicate each item that is being requested on the pricing documentation. Do not modify, alter or change the pricing documentation.

    If billing for accessories over $400, bill on a separate claim. Make sure the HCPCS code, modifiers and description on the claim match the same information on the authorization. Enter the authorization number in the authorization field on the claim information table of MN–ITS.

    Rate/Report this pageReport/Rate this page

    © 2017 Minnesota Department of Human Services Updated: 7/5/17 2:37 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 7/5/17 2:37 PM