CurrentRegencePolicy 23

Patient Lifts and Seat Lifts

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This policy governs coverage and medical necessity review for patient lifts, multi-positional transfer systems, and seat lift devices for members whose mobility and transfer needs meet specified criteria. It applies only to certain member contracts, and contract language takes precedence over the policy.

Policy Summary

PayerRegence

PolicyPatient Lifts and Seat Lifts

Policy CodePolicy N/A

Change TypeNo material change

Effective DateAugust 1, 2026

Last ReviewJun 1, 2026

Next Review DateApril 1, 2027

Key ActionCheck the preauthorization website for the member's contract to confirm whether requirements apply, then submit the required clinical documentation for review.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

3Equipment categories with medical-necessity criteria

2+Required caregivers for patient-lift transfers

SupineAdditional transfer requirement

Not coveredPermanently anchored and property-fixture lifts

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CurrentRegencePolicy 23

Patient Lifts and Seat Lifts

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Sign up for regence Policy 23 alerts

Get alerted when Policy 23 changes without checking for updates manually.

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Policy Summary

PayerRegence

PolicyPatient Lifts and Seat Lifts

Policy CodePolicy N/A

Change TypeNo material change

Effective DateAugust 1, 2026

Last ReviewJun 1, 2026

Next Review DateApril 1, 2027

Key ActionCheck the preauthorization website for the member's contract to confirm whether requirements apply, then submit the required clinical documentation for review.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

3Equipment categories with medical-necessity criteria

2+Required caregivers for patient-lift transfers

SupineAdditional transfer requirement

Not coveredPermanently anchored and property-fixture lifts

Coverage Criteria

Patient lifts

A patient lift may be considered medically necessary when ALL of the following are met.

Patient lift criteria

Transfer assistance: Transfer between bed and a chair, wheelchair, or commode requires the assistance of more than one person.More than one person
Bed confinement: The individual would be bed-confined without use of the lift.Bed-confined without lift

Multi-positional transfer systems

A multi-positional transfer system may be considered medically necessary when ALL of the following are met.

Multi-positional transfer system criteria

Transfer assistance: Transfer between bed and a chair, wheelchair, or commode requires the assistance of more than one person.More than one person
Bed confinement: The individual would be bed-confined without use of the lift.Bed-confined without lift
Supine positioning is needed for transfers due to the individual's condition.Supine positioning required

Seat lift devices

A seat lift device may be considered medically necessary when ALL of the following are met.

Seat lift criteria

Device type: The device is not a spring-release seat lift.Not spring-release
Underlying condition: The individual has severe arthritis or a neuromuscular condition that prevents them from standing up from any chair in the individual's home.Severe arthritis or neuromuscular condition
Prescription: A provider has prescribed the seat lift to treat the individual's condition.Provider prescription

Permanently anchored patient lifts and property-fixture devices are not covered. This includes ceiling lifts, bathroom lifts, van lifts, stair lifts, and devices permanently fixed to a ceiling or wall. These items are treated as home or motor-vehicle modifications rather than durable medical equipment.

Patient lifts are not medically necessary when the applicable criteria are not met. This includes situations in which the individual is not otherwise bed-confined or can be transferred between the bed and a chair, wheelchair, or commode with the assistance of a single caregiver.

Multi-positional transfer systems are not medically necessary when the applicable criteria are not met. In particular, they are not medically necessary when the individual does not require both a lift system and supine positioning during transfer.

Seat lift devices are not medically necessary when the applicable criteria are not met, including when the individual can stand without assistance, is not ambulatory when standing, or uses a spring-release device. Spring-release mechanisms use a sudden, catapult-like action and lack the safety of devices that can be smoothly operated by the patient.

Coding and Equipment Requirements

HCPCS CodesHCPCS

E0625	Patient lift, bathroom or toilet, not otherwise classified.
E0627	Seat lift mechanism, electric, any type.
E0629	Seat lift mechanism, nonelectric, any type.
E0630	Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s), or pad(s).
E0635	Patient lift, electric, with seat or sling.
E0636	Multipositional patient support system, with integrated lift, patient accessible.
E0639	Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories.
E0640	Patient lift, fixed system, includes all components/accessories.
E1035	Multi-positional patient transfer system, with integrated seat, operated by caregiver, patient weight capacity up to and including 300 lbs.
E1036	Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs.

Caregiver assistance

ThresholdMore than one person is required for transfer.

Transfer contextTransfer is between bed and a chair, wheelchair, or commode.

Applies toPatient lifts and multi-positional transfer systems.

Bed confinement

ThresholdThe individual would be bed-confined without use of the lift.

Applies toPatient lifts and multi-positional transfer systems.

Coverage condition

Provider Actions

Prior Authorization

Confirm authorization requirements

Check the preauthorization website for the member's contract to confirm whether requirements apply. Submit the required clinical documentation for review of the policy criteria.

Documentation Required

Submit required clinical documentation

Submit the equipment or device make, model, and manufacturer name, the physician's order when applicable, and pertinent medical records and chart notes for the request.

Current condition and relevant past medical history
Mobility needs
Specific device needs, such as a requirement for supine transfers

Background

Patient lifts assist caregivers in transferring individuals who cannot assist with the transfer, commonly between a bed and a chair, wheelchair, or commode. A lift may use a seat or sling with a mechanical, hydraulic, or electric lifting mechanism. Multi-positional transfer systems support individuals who require supine positioning during transfer. Seat lift devices assist individuals who cannot rise from a seated position because of a qualifying condition but remain ambulatory once standing.

Definitions

Patient lift

PurposeAssists a caregiver in transferring an individual between bed and a chair, wheelchair, or commode.

Individual needUsed when the individual is unable to assist with the transfer or is otherwise bed-confined.

MechanismUses a seat or sling and a mechanical, hydraulic, or electric lifting mechanism.

Multi-positional transfer system

PurposeAllows transfer of individuals who require supine positioning during the transfer.

PositioningThe apparatus can be adjusted for different positions, including supine positioning.

Typical design

Medical Necessity Framework

DME medical necessity

Coverage may be considered when all criteria for the applicable equipment category are met.

Applicable equipment criteria

Patient lift: The request meets all patient-lift criteria.
Multi-positional transfer system: The request meets all multi-positional-transfer-system criteria.
Seat lift device: The request meets all seat-lift criteria.

Documentation Requirements

Documentation Required

Support the request with clinical documentation

Clinical documentation supporting the policy criteria is required for review. Include the make, model, and manufacturer name; the physician's order when applicable; and pertinent medical records and chart notes addressing the current condition, relevant history, mobility needs, and specific device needs.

Not Covered Equipment

The following are not covered: permanently anchored patient lifts and property-fixture devices, including ceiling lifts (E0640), bathroom lifts (E0625), van lifts, and stair lifts. These devices are considered home or motor-vehicle modifications rather than durable medical equipment. Integrated seat-lift recliner chairs are also not covered as durable medical equipment because they are furniture.