Standing Frames - DME.CU.104.A
EVICORE-DME-70FAE46D
Covered: Standing frames (HCPCS E0638, E0641, E0642) are covered only when documented evidence shows inability to stand without support due to muscle tone abnormalities or decreased motor control, inability to ambulate, prescription by a physician trained in function/rehab/neuromuscular care for daily home use, anticipated use ≥12 months, a successful trial with tolerance of upright positioning, and patient/caregiver ability to operate the device. Excluded: devices for short‑term or non‑home use, for ambulatory individuals, without a trial, without appropriate physician oversight, or not intended for ≥12 months are not covered.
"A standing frame is indicated when there is documentation of all of the following:"
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