Commercial

Medical Policy

Title:

Standing Frames

Policy #:

05.00.71c

Policy

MEDICALLY NECESSARY

A nonpowered, single-position standing frame, a nonpowered multipositional standing frame, or a nonpowered dynamic standing frame is considered medically necessary and, therefore, covered when it is ordered following an appropriate rehabilitation evaluation, and all of the following indications are met:

The individual has a neuromuscular condition with an impaired ability to stand but, once standing, can maintain the standing position because of residual strength in the hips, legs, and lower body.
The individual requires the use of a wheelchair as a means of mobility.
The standing frame is appropriate for the individual's disability and size.
The standing frame is intended for use in the home.
The individual has a caregiver who is available, willing, and able to provide assistance with the standing frame.

In addition to the above criteria, a nonpowered multipositional standing frame system is considered medically necessary and, therefore, covered when an individual has a medical condition that requires frequent changes in positioning.

In addition to the above criteria, a nonpowered mobile (dynamic) standing frame system is considered medically necessary and, therefore, covered when an individual has the upper arm strength to self-propel the device.

NOT MEDICALLY NECESSARY

All other uses for nonpowered standing frames are considered not medically necessary and, therefore, not covered because the available published peer-reviewed literature does not support their use in the treatment of illness or injury.

NOT ELIGIBLE FOR SEPARATE REIMBURSEMENT

Accessories outside of the basic nonpowered standing frame are not eligible for separate reimbursement.

REQUIRED DOCUMENTATION

The Company may conduct reviews and audits of services to our members regardless of the participation status of the provider. Medical record documentation must be maintained on file to reflect the medical necessity of the care and services provided. These medical records may include but are not limited to: records from the professional provider's office, hospital, nursing home, home health agencies, therapies, and test reports.

STANDARD WRITTEN ORDER REQUIREMENTS
Before submitting a claim to the Company, the supplier must have on file a timely, appropriate, and complete standard written order for each item billed that is signed and dated by the professional provider who is treating the member. Requesting a provider to sign a retrospective standard written order at the time of an audit or after an audit for submission as an original standard written order, reorder, or updated order will not satisfy the requirement to maintain a timely professional provider order on file.

PROOF OF DELIVERY REQUIREMENTS
Medical record documentation must include a contemporaneously prepared delivery confirmation or member's receipt of supplies and equipment. The medical record documentation must include a copy of delivery confirmation if delivered by a commercial carrier and a signed copy of delivery confirmation by member/caregiver if delivered by the durable medical equipment (DME) supplier/provider. All documentation is to be prepared contemporaneous with delivery and be available to the Company upon request.

CONSUMABLE SUPPLIES (WHEN APPLICABLE)
The DME supplier must monitor the quantity of accessories and supplies an individual is actually using. Contacting the individual regarding replenishment of supplies should not be done earlier than approximately 7 days prior to the delivery/shipping date. Dated documentation of this contact with the individual is required in the individual's medical record. Delivery of the supplies should not be done earlier than approximately 5 days before the individual would exhaust their on-hand supply.

For specified DME items, documentation of a face-to-face encounter between the treating professional provider and the individual meeting the above requirements, including an assessment of the individual's clinical condition supporting the need for the prescribed DME item(s), must be provided to and kept on file by the DME supplier.

If required documentation is not available on file to support a claim at the time of an audit or record request, the DME supplier may be required to reimburse the Company for overpayments.

Guidelines

BENEFIT APPLICATION

Subject to the terms and conditions of the applicable benefit contract, standing frames are covered under the medical benefits of the Company’s products when the medical necessity criteria listed in this medical policy are met.

However, services that are identified in this policy as not medically necessary or a benefit exclusion are not eligible for coverage or reimbursement by the Company.

BENEFIT CONTRACT EXCLUSION

Durable medical equipment (DME) is equipment that is designed to withstand repeated use, is primarily and customarily used for a medical purpose, is not useful to a person without an illness or injury requiring mobility assistance and is appropriate for use in the home. Plans may not provide coverage for customized or convenience‑based enhancements, equipment of a nonmedical nature, disposable supplies, or structural modifications to homes or vehicles. Individual benefits need to be verified.

For Plans that exclude durable medical equipment items that are not primarily medical in nature, a standing frame with a motorized or powered feature may not meet the applicable Plan's definition of DME and as such may not be covered under the terms of the applicable benefit contract or eligible for reimbursement consideration. Individual benefits need to be verified.

Equipment with features of a medical nature that are not required for the individual's condition. The therapeutic benefits of the item cannot be clearly disproportionate to its cost if there exists a medically necessary and realistically feasible alternative item that serves essentially the same purpose.

US FOOD AND DRUG ADMINISTRATION (FDA) STATUS

Some standers are regulated by the FDA through the 510K marketing process. Other devices may be 510K exempt and do not require clearance for marketing from the FDA.

Description

A standing frame is known by many terms, such as a stand, a stander, standing technology, a standing aid, a standing device, a stand-alone, or a standing box. It is an assistive device typically used by an individual who requires a wheelchair for mobility. A standing frame provides alternative positioning from sitting in a wheelchair, and also supports the individual in an upright standing position.

Per available literature, nonambulatory, physically disabled individuals may benefit from the use of a standing frame system for a number of health reasons, such as increasing range of motion; maintaining bone density and muscle strength; increasing cardiovascular endurance; reducing swelling in the lower limbs; decreasing spasticity (muscle overactivity); preventing pressure ulcers; increasing the ability to effectively move air flow through the lungs with improvement in pulmonary function; and improving bowel and bladder function.

Standing frames can be divided into three types: passive (static) stander, mobile (dynamic) stander, and active stander. The best type for an individual depends on height, weight, medical condition, and functional needs. There are a variety of standing frame models available within each type, including motorized or powered and nonmotorized. The type and model of a standing system that is best for an individual depends on the extent of the disability and the size of the individual.

The therapeutic benefits of a powered or motorized option standing frame cannot be clearly disproportionate to its cost if there exists a medically appropriate and realistically feasible alternative item that serves essentially the same purpose.

NONPOWERED PASSIVE (STATIC STANDERS)

The passive (static) standers remain in place and cannot be self-propelled. There are many models of passive standers. Two examples are sit-to-stand and multipositional standers.

Sit-to-stand standers (e.g., EasyStand StrapStand™and EasyStand Evolv™) are highly functional because they can be used in sitting and standing and can usually be positioned at any angle between sitting and standing. A sit-to-stand stander requires the individual to have head control and fairly good trunk control.

Multipositional standers (e.g., EasyStand Bantam™) can be reversed so the individual can be placed in a prone (on the belly) or supine (on the back) position, depending on the individual’s abilities. These standers can be more difficult to use because they are sometimes closer to the floor, and transferring the individual in the stander can require two people; however, there are benefits to the prone/supine stander. For example, if the individual has poor head control, supine positioning can be employed. Then, when the individual develops better head control, the same stander can be utilized in a prone position to develop stronger neck and trunk muscles.

NONPOWERED MOBILE (DYNAMIC) STANDERS

A mobile (dynamic) stander allows individuals with upper body strength to self-propel. There are various models of mobile standers (e.g., Standing Dani®, Rifton Mobile Standers™, EasyStand Evolv™ Mobile, Rabbit Mobile Standing Frame and EasyStand Bantam™ Mobile option). A sit-to-stand stander uses a series of pulleys and wheels that allow the individual to self-propel while in a standing position, with minimal effort. Some mobile standers have a power option, in which the wheels are driven by motors and the stander is controlled by a joystick similar to a power wheelchair. Mobile standers are best for individuals who have good head control and upper body strength. For example, individuals diagnosed with spinal cord injuries, spina bifida, and cerebral palsy can benefit from both the added mobility and the standing position that a mobile stander provides.

NONPOWERED ACTIVE STANDERS

The active standers create reciprocal movement of the arms and legs while standing. This is a newer option in standing frames (e.g., EasyStand® Glider™). These standers have a “glider” attachment that allows the person to use either the arms alone or a combination of arms and legs to operate the mechanism and “glide” in a reciprocal walking-type pattern. Like the mobile stander, the individual in the active stander needs good head control and upper body strength, unless there is a caregiver who is able to assist.

SUMMARY

There are various types and many models available within each category of stander. The standing frame that best benefits the individual should be based on the extent of the individual's disability, size, and home environment.

References

Alizadeh-Meghrazi M, Masani K, Popovic MR, Craven BC. Whole-body vibration during passive standing in individuals with spinal cord injury: effects of plate choice, frequency, amplitude, and subject's posture on vibration propagation. PM R. 2012;4(12):963-975.

ClinicalTrials.gov. Effects of different time period of standing frame on spasticity and gait in children with spastic cerebral palsy. [Clinical Trials. GOV Website]. 11/10/2021. Available at: https://www.clinicaltrials.gov/ct2/show/NCT05113433. Accessed May 14, 2026.

Dunn RB, Walter JS, Lucero Y, et al. Follow-up assessment of standing mobility device users. Assist Technol. 1998;10:84-93.

Eng JJ, Levins SM, Townson AF, et al. Use of prolonged standing for individuals with spinal cord injuries. Phys Ther. 2001;81(8):1392-1399.

Gibson SK, Sprod JA, Maher CA. The use of standing frames for contracture management for nonmobile children with cerebral palsy. Int J Rehabil Res. 2009;32(4):316-323.

Goktepe AS, Tugcu I, Yilmaz B, et al. Does standing protect bone density in patients with chronic spinal cord injury? J Spinal Cord Med. 2008;31(2):197-201.

Herman D, May R, Voge L, et al. Quantifying weight-bearing by children with cerebral palsy while in passive standers. Pediatr Phys Ther. 2007;19(4):283-287.

Holland D, Holland T. Taking a stand. Rehab Manag. 2006;19(2):44-49.

Lutz J, Chen F, Kasper C. Hypokinesia-induced negative net calcium balance reverse by weight bearing exercise. Aviation Space Environ Med. 1987;58:308-314.

Kecskemethy HH, Herman D, May R, et al. Quantifying weight bearing while in passive standers and a comparison of standers. Dev Med Child Neurol. 2008;50(7):520-523.

Taylor K. Factors affecting prescription and implementation of standing-frame programs by school-based physical therapists for children with impaired mobility. Pediatr Phys Ther. 2009;21(3):282-288.

Thompson CR, Figoni SF, Devocelle HA, et al. Effect of dynamic weight bearing on lower extremity bone mineral density in children with neuromuscular impairment. Clinical Kinesiology. 2000;54:13-18.

U.S. Food and Drug Administration 510(k) Premarket Notification Database. EasyStand Evolv™. No. K062402. Rockville, MD: FDA. [FDA Web site]. 09/21/2006. Available at: https://www.accessdata.fda.gov/cdrh_docs/pdf6/K062402.pdf. Accessed May 14, 2026.

U.S. Food and Drug Administration 510(k) Premarket Notification Database. Rabbit Mobile Standing Frame™. No. K030882. Rockville, MD: FDA. [FDA Web site]. 04/04/2003. Available at: https://www.accessdata.fda.gov/CDRH510K/K030882.pdf. Accessed May 14, 2026.

Walter JS, Sola PG, Sacks J, et al. Indications for a home standing program for individuals with spinal cord injury. J Spinal Cord Med. 1999;22(3):152-158.

Coding

CPT Procedure Code Number(s)

N/A

ICD - 10 Procedure Code Number(s)

N/A

ICD - 10 Diagnosis Code Number(s)

N/A

HCPCS Level II Code Number(s)

MEDICALLY NECESSARY

THE FOLLOWING CODES ARE USED TO REPRESENT A NON-POWERED STANDING SYSTEM:

E0638 Standing frame/table system, one position (e.g., upright, supine, or prone stander), any size including pediatric, with or without wheels

E0641 Standing frame /table system, multi-position (e.g., 3-way stander), any size including pediatric, with or without wheels

E0642 Standing frame/table system, mobile (dynamic stander), any size including pediatric

BENEFIT CONTRACT EXCLUSION

The following code is used to represent a powered standing system:

E0637 Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels

Revenue Code Number(s)

N/A

MPMiscCodesNarrativesPub

Coding and Billing Requirements

Cross Reference

Policy History

Revisions From 05.00.71c:

06/24/2026	This policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.
04/02/2025	The policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.
08/07/2024	The policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.
05/17/2023	The policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.

03/23/2022

The policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.

10/21/2020	The policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.
06/19/2019	This policy has been reissued in accordance with the Company's annual review process.
02/15/2018	This policy was reviewed and reissued in accordance with the Company's Policy Confirmation Review track. The references were updated accordingly. The policy was updated to be consistent with current template wording and format. The adoptable source for this policy are the Food and Drug Administration (FDA) labeling, literature, text books, articles.

Effective 10/05/2017 this policy has been updated to the new policy template format.

Version Effective Date:

3/22/2017

Version Issued Date:

3/22/2017

Version Reissued Date:

6/24/2026