Medicare Advantage

Medical Policy

Title:

Standing Frames

Policy #:

MA05.055

Policy

This policy uses coverage criteria developed solely based on applicable Medicare statutes, regulations, NCDs, LCDs, CMS manuals and other applicable Medicare coverage documents

NOT COVERED

A standing frame is not covered by the Company because it is an item not covered by Medicare. Therefore, it is not eligible for reimbursement consideration.

Guidelines

This policy is consistent with Medicare’s coverage determination.

BENEFIT APPLICATION

Subject to the terms and conditions of the applicable Evidence of Coverage, a standing frame is not eligible for payment under the medical benefits of the Company’s Medicare Advantage products because this item is considered not covered.

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, standing table 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.

References

Centers for Medicare & Medicaid Services (CMS). National Coverage Determination (NCD) 280.1 for DME Reference List. [CMS Web site]. Effective 06/09/2025. Available at: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&ncdver=4&NCDSect=280.1&bc=BEAAAAAAAQAAAA==&=. Accessed May 14, 2026.

Noridian Healthcare Services, LLC. Noncovered Items. [Noridian Web site]. Updated 11/18/2024. Available at: https://med.noridianmedicare.com/web/jadme/topics/noncovered-items. Accessed May 14, 2026.

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)

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

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

Revenue Code Number(s)

N/A

MPMiscCodesNarrativesPub

Coding and Billing Requirements

Cross Reference

Policy History

Revisions From MA05.055:

06/24/2026	This policy has been reviewed and reissued to communicate the Company’s continuing position on standing frames.
04/02/2025	This 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.
01/01/2024	Effective 01/01/2024 this policy applies to New Jersey Medicare Advantage (MA) lines of business.
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 has been reviewed and reissued to communicate the Company’s continuing position on Standing Frames.
03/15/2017	This policy has been reviewed and reissued to communicate the Company’s continuing position on Standing Frames
03/16/2016	This version of the policy will become effective on 03/16/2016. This policy has been reviewed and reissued to communicate the Company’s continuing position on Standing Frames
01/21/2015	The policy has been reviewed and reissued to communicate the Company’s continuing position on Standing Frames.
01/01/2015	This is a new policy.

Version Effective Date:

1/1/2024

Version Issued Date: