This bill aims to improve access to ultralightweight manual wheelchairs for Medicare beneficiaries by establishing separate billing codes and allowing suppliers to charge the difference between Medicare payment and actual cost.
John Joyce
Representative
PA-13
The "Choices for Increased Mobility Act of 2025" amends the Social Security Act to change how Medicare pays for ultralightweight manual wheelchairs. It mandates separate billing codes for these wheelchairs based on their construction material and ensures suppliers of titanium or carbon fiber wheelchairs are paid without payment reductions. This bill also lets suppliers charge beneficiaries the price difference between the Medicare payment and the wheelchair's cost, with potential requirements for suppliers to disclose out-of-pocket expenses to beneficiaries beforehand.
Medicare Changes Coming for Ultralight Wheelchairs: New Codes and Potential Costs in 2026
The "Choices for Increased Mobility Act of 2025" tweaks how Medicare handles certain manual wheelchairs, specifically the ultralightweight kind. Starting January 1, 2026, the government will use new codes to classify these wheelchairs based on whether they're made from titanium or carbon fiber. (SEC. 2).
Rolling into Changes
The main shift? While Medicare will pay its usual rate for these high-tech wheelchairs, suppliers can now bill you directly for any extra cost above what Medicare covers. Think of it like this: Medicare sets a price, but if the chair costs more, you're on the hook for the difference. The bill does say suppliers might have to tell you about these potential out-of-pocket costs upfront (SEC. 2), but it's not super clear on the details of that requirement.
Real-World Rollout
For folks who rely on these wheelchairs, this could be a mixed bag. On one hand, it might make it easier to get your hands on top-of-the-line models made with materials like titanium or carbon fiber. These materials are known for making the chair lighter and more durable, which can be a big deal for everyday use.
Imagine a delivery driver who uses a wheelchair and needs to constantly move in and out of their vehicle and navigate different terrains. Or picture a retail worker who needs to be mobile and maneuver around a store all day. A lighter, stronger chair could make a real difference in their daily grind.
But – and this is a big but – it also means you could end up paying more out of pocket. The bill doesn't put any limits on how much extra suppliers can charge. This could be significant, especially since these aren't your standard-issue wheelchairs. We're talking about specialized equipment, and those costs can add up fast. It will be important to get a clear breakdown of all charges before committing to a specific wheelchair.
The Bottom Line
This bill is trying to give people more choices, but it's doing it in a way that could also open the door to higher costs. It all comes down to how this plays out in the real world, and whether the requirement for suppliers to disclose potential costs is actually enforced, and how.