CMS reimbursement can affect whether complex rehab suppliers are able to provide Dynamic Backs to people who need them. If reimbursement is significantly below the cost of providing the equipment, access may become more difficult even when the Dynamic Back is medically necessary.

A Dynamic Back may be recommended for people with spasticity, severe extensor tone, repetitive rocking or other movement patterns that create significant forces against the wheelchair. It allows controlled movement in response to those forces rather than requiring the person to push against a completely static seating system.

Depending on the individual, repeated force against rigid seating may contribute to equipment damage, loss of positioning, pain, pressure concerns or injury. In this article, Daniel’s parents describe broken mounting hardware, pressure injuries and orthopedic problems before he received his Dynamic Back.

Clinicians may recommend Dynamic Backs when controlled movement can address specific seating and mobility needs. The physical therapist featured in this article reports using them with people who have spasticity, severe extensor tone, significant rocking behaviors, pain and sitting intolerance.

Yes. Coverage and adequate reimbursement are separate issues. An item may be considered medically necessary, but if the reimbursement amount does not cover the cost of providing it, suppliers can face significant barriers to delivering that equipment. This is the concern behind the comments shared throughout this Seating Dynamics series.