The "Choices for Increased Mobility Act of 2025" amends the Social Security Act to establish separate Medicare payment rules and codes for ultralightweight manual wheelchairs, potentially allowing suppliers to charge patients the difference between the standard payment and the actual cost for certain models.
Marsha Blackburn
Senator
TN
The "Choices for Increased Mobility Act of 2025" amends the Social Security Act to change Medicare's payment rules for ultralightweight manual wheelchairs. Starting in 2026, separate billing codes will be created based on the wheelchair's material. For titanium or carbon fiber wheelchairs, suppliers can charge the individual the difference between Medicare's payment and the actual cost, potentially leading to out-of-pocket expenses for the beneficiary.
Medicare to Split Billing Codes for Ultralight Wheelchairs in 2026, Allowing Higher Out-of-Pocket Costs
The "Choices for Increased Mobility Act of 2025" changes how Medicare handles ultralightweight manual wheelchairs. Starting January 1, 2026, the bill directs the Secretary to create separate billing codes (HCPCS codes) specifically for chairs made with titanium or carbon fiber bases (SEC. 2). This differs from the current system, which doesn't distinguish based on those materials.
Wheelchair Codes Get an Upgrade
The core of the bill revolves around these new billing codes. While Medicare will continue to pay its standard rate for these wheelchairs under the existing rules (Section 1834(a)(1)(A) of the Social Security Act), suppliers gain a new ability: they can now bill the patient for the difference between what Medicare pays and the supplier's actual charge (SEC. 2). Think of it like this: if Medicare covers $2,000, but the supplier's price is $2,500, they can now charge the patient that extra $500.
Real-World Rollout
For someone needing an ultralightweight wheelchair, this could mean a wider range of choices, but potentially at a higher price. Imagine a construction worker who relies on a wheelchair and prefers the durability of titanium. Under this bill, they might have easier access to that specific chair, but they could also face a bigger bill. The same goes for, say, a graphic designer who prefers the lighter weight of carbon fiber – more options, but potentially higher costs.
The bill does give the Secretary the power to require suppliers to disclose these potential extra costs before a patient buys or rents the wheelchair (SEC. 2). This is crucial for transparency, so people aren't hit with surprise bills. However, the bill doesn't define any limits or guidelines on how much extra suppliers can charge.
The Bottom Line
While the "Choices for Increased Mobility Act of 2025" aims to provide more options for those needing ultralightweight wheelchairs, it introduces a potential financial burden. The creation of separate billing codes for titanium and carbon fiber models could lead to higher quality, more durable chairs being available. However, the ability for suppliers to charge patients the difference between Medicare's payment and their own price tag raises concerns about affordability and potential price gouging, without clear limits on those extra charges.