CMS Updates Wheelchair Seating Coverage Policy

WOCN has been working with the stakeholder community to urge CMS to update its coverage policies for wheelchair seating to reflect current clinical practice measures to prevent development of pressure injury. In a 10/02/25 update to its Wheelchair Seating Policy Article (A52505) CMS has created new criteria for the approval of wheelchair seat/back cushions. The new guidance expands coverage to allow for pressure injury prevention regarding wheelchair seating accessories. The policy no longer requires specific ICD-10 diagnosis codes; instead, ordering providers must provide documentation of clinical need, such as the patient’s specific postural asymmetries, skin integrity issues, or inability to perform weight shifts. The clinical documentation must demonstrate the medical necessity of the seating component to improve function or prevent complications. We would encourage ordering providers to check with your facility’s billing and coding staff to ensure your order reflect these changes. The revised policy is effective as of 10/01/2025.