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Medicare Payment Rules Clarified for Ultralight Titanium and Carbon Fiber Wheelchairs.

This Act modifies Medicare Part B payment rules for ultralight manual wheelchairs. Starting in 2026, wheelchairs made with premium materials like titanium or carbon fiber will have separate billing codes. While Medicare will pay its standard amount, suppliers are allowed to charge the beneficiary the difference between the Medicare payment and the actual cost of the specialized wheelchair.
Key points
Separate Medicare billing codes will be established for ultralight wheelchairs based on whether they use titanium or carbon fiber materials (effective January 1, 2026).
Medicare beneficiaries may face out-of-pocket costs covering the price difference for these specialized, high-end wheelchairs.
Suppliers may be required to notify beneficiaries about their potential financial liability before the purchase or rental.
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Additional Information
Print number: 118_S_5540
Sponsor: Sen. Blackburn, Marsha [R-TN]
Process start date: 2024-12-16