Patient Lifts and Seat Lift Mechanisms

Revised: May 20, 2025

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Noncovered Services

· Authorization

· Billing

Overview

A patient lift is used to transfer the person from one surface to another. A seat lift mechanism is used to allow a person to move from a seated position to a standing position.

Eligible Providers

The following providers may provide patient lifts and seat lift mechanisms:

· Federally qualified health centers

· Home health agencies

· Indian Health Services

· Medical suppliers

· Pharmacies

· Rural health clinics

TPL and Medicare
Providers must meet provider criteria, including accreditation, for third-party insurance or for Medicare to assist members for whom Minnesota Health Care Programs (MHCP) is not the primary payer.

MHCP quantity limits and thresholds apply to all members unless only Medicare coinsurance or deductible is requested.

Eligible Members

Patient lifts and seat lift mechanisms are covered for Medical Assistance and MinnesotaCare members who meet coverage criteria. Members in nursing facilities and intermediate care facilities for people with developmental disabilities are not eligible for patient lifts or seat lift mechanisms.

Covered Services

Codes: E0621, E0627, E0629, E0630, E0635, E0636, E0639

Hydraulic or mechanical patient lifts (E0630) are covered for members who meet all of the following criteria:

· The member requires help from another person to transfer between a wheelchair, bed, commode or other surfaces in the home; and

· The member cannot be safely transferred without a lift due to the member’s medical condition or the caregiver’s limitations; and

· The lift is documented as fitting in all necessary parts of the member’s home

Electric patient lifts (E0635) are covered for members who meet criteria for a hydraulic or mechanical lift and who meet one of the following criteria:

· The member has a medical condition that prevents safe transfer using a hydraulic or mechanical lift; or

· The primary caretaker is unable to operate a hydraulic or mechanical lift but can operate an electric lift and can perform all necessary cares

Multi-positional patient support systems with integrated lift (E0636) and moveable patient lifts (E0639) are covered for members who meet criteria for a patient lift and whose unique medical needs cannot be met with a less costly lift.

Seat lift mechanisms (E0627, E0629) are covered for members who meet all of the following criteria:

· The member has arthritis of the hip or knee, neuromuscular disease or another medical condition that affects the member’s strength or mobility; and

· The member is unable to stand up from a regular armchair at home; and

· Once standing, the member has the ability to ambulate independently or with a properly fitted walker or cane

Noncovered Services

MHCP does not cover the following:

· Nonelectric seat lift mechanisms that operate by spring-release mechanism because they are not the community standard of care

· Hoyer converters that convert a manual lift into an electric lift

· Chairs for which seat lift mechanisms are intended because they are furniture

· Home and vehicle modifications, including:

· Vehicle lifts

· Platform lifts

· Stair lifts

· Elevators

· Wheelchair lifts

· Nonportable ramps

· Ceiling-mounted lifts

· Wall-mounted lifts

Authorization

Authorization is required for the following:

· Seat lift mechanisms (E0627, E0629)

· Multipositional patient support systems (E0636)

· Moveable patient lifts (E0639)

· Rental or purchase of a patient lift when the patient’s current lift, regardless of lift type, is less than five years old

Authorization is not required for patient lifts except as described above. If requesting authorization for a patient lift, clearly state on the authorization request the reason authorization is requested. Submit authorization requests with required documentation to the authorization Medical Review Agent.

Documentation must include the following:

· Member weight and height, and general strength and age of primary caretaker

· Medical condition that requires the specific kind of lift requested

· Description of the current method of transfer and why it does not meet the member’s needs

· Description of how the lift will be used in critical areas of the residence

· Plan of care

· Satisfactory member and caretaker use of the lift

· Documentation that the lift will fit in all necessary areas of the home

· Consideration of less-costly alternatives and why alternatives are not appropriate for the member’s needs

Billing

Providers are responsible to coordinate services. Refer to the Billing Policy Overview section of the MHCP Provider Manual for general billing information.

Bill patient lift and seat mechanisms using MN–ITS 837P Professional. Refer to the Billing for Durable Medical Equipment, Medical Supplies, Prosthetics, Orthotics, and Augmentative Devices MN–ITS user manual for general billing requirements and guidance when submitting claims.

· All hydraulic, mechanical or electric lifts include a seat or sling with initial dispensing. Do not bill separately.

· If the member has Medicare, MHCP will pay only the deductible and coinsurance on any item for which Medicare made payment, regardless of any MHCP prior authorization.

· If the member has Medicare, any items for which Medicare denies payment must meet MHCP coverage and authorization requirements.

· Shipping and delivery costs are included in the MHCP maximum allowable payment and may not be billed separately to MHCP or the member.

· Patient lifts and seat lift mechanisms are expected to serve the member for at least five years. If a device is stolen or damaged beyond repair, a replacement device may be covered with authorization. Equipment should not be replaced if it is still usable and meets the patient’s needs after five years.

· Refer to the Non-Mobility Equipment Repairs section of the MHCP Provider Manual for additional billing requirements for repairs to lift equipment.