S-247-119
Read twice and referred to the Committee on Finance.
Sponsored by Marsha Blackburn (R-TN)
What it does
This bill would amend Medicare Part B to create separate billing codes (HCPCS codes) for ultralightweight manual wheelchairs based on whether their frame is made of titanium or carbon fiber versus other materials. Starting January 1, 2026, Medicare would pay suppliers at the standard durable medical equipment rate for all ultralightweight wheelchairs, but suppliers could charge beneficiaries the difference between that Medicare payment and the supplier's actual price for titanium or carbon fiber models. The bill would also allow the Secretary of Health and Human Services to require suppliers to notify beneficiaries in advance of any additional out-of-pocket costs they may face.
Who benefits
Medicare beneficiaries who need ultralightweight manual wheelchairs and prefer or medically require titanium or carbon fiber frames, as these materials are lighter and more durable. Wheelchair suppliers and manufacturers who produce premium-material wheelchairs, as the bill creates a clearer billing pathway for these products. Beneficiaries who currently cannot access these chairs due to billing ambiguity would gain a defined coverage route. Titanium and carbon fiber material suppliers and the broader durable medical equipment industry would benefit from a more predictable reimbursement framework.
Who is hurt
Medicare beneficiaries with limited incomes who may face new out-of-pocket charges for titanium or carbon fiber wheelchairs that were previously covered at the standard rate without an additional balance bill. Beneficiaries who are unaware of the cost difference and do not receive or understand the required advance notice could face unexpected bills. Suppliers of standard-material wheelchairs may face competitive disadvantage if premium-material chairs become more accessible. Medicaid programs that wrap around Medicare coverage could face increased cost-sharing obligations for dual-eligible beneficiaries.
Supporters argue
Supporters argue that the current Medicare billing system does not distinguish between wheelchair frame materials, creating a reimbursement gap that effectively prevents beneficiaries from accessing clinically superior titanium and carbon fiber chairs. They contend that these materials meaningfully improve mobility, reduce secondary injuries, and lower long-term healthcare costs — and that the bill's advance notice requirement ensures beneficiaries can make informed choices rather than face surprise bills. The bipartisan sponsorship (Blackburn and Duckworth) reflects broad agreement that the existing coding structure fails patients who need lighter, more durable equipment.
Opponents argue
Opponents argue that allowing suppliers to balance-bill beneficiaries for the cost difference between Medicare's payment rate and premium-material wheelchairs effectively shifts costs onto some of Medicare's most vulnerable users — people with disabilities and mobility impairments who may have fixed incomes. They contend that without a cap on the allowable balance-bill amount, the provision could expose beneficiaries to unpredictable and potentially large out-of-pocket charges, and that the notice requirement is discretionary ("may require"), providing no guaranteed protection. Critics may also argue this creates a two-tiered system where access to better equipment depends on ability to pay.