This document addresses lifting devices for use in the home, including a multi-positional transfer system to assist a caregiver(s) in transferring an individual to and from a bed to a chair (or other locations) when the individual is unable to assist with the transfer.

Note: Please see the following related documents for additional information:

• CG-DME-10 Durable Medical Equipment
• CG-DME-25 Seat Lift Mechanisms

Clinical Indications

Medically Necessary:

1. A hydraulic or mechanical lift is considered medically necessary for an individual when all of the following criteria are met:
   1. When it is used for the transfer of the individual between a bed and a chair, wheelchair, commode, or shower/bath chair; and
   2. When transfers cannot be performed independently and require the assistance of more than one person; and
   3. When the individual would be bed confined without the use of a lift; and
   4. When the individual’s condition is such that periodic movement is necessary to improve his/her condition or to arrest or retard deterioration of their condition.
2. A canvas or nylon sling or seat for a hydraulic or mechanical lift is considered medically necessary as an accessory when ordered as a replacement for the original equipment item and the criteria listed above are met.
3. A multi-positional transfer system is considered medically necessary in lieu of any of the following mobility assistive equipment, including but not limited to canes, crutches, walkers, rollabout chairs, transfer chairs, manual wheelchairs, power-operated vehicles, or power wheelchairs, when both of the following criteria are met:
   1. The criteria for a hydraulic or mechanical lift are met; and
   2. The individual requires supine positioning for transfers.

Not Medically Necessary:

1. A hydraulic or mechanical lift or multi-positional transfer system is considered not medically necessary when the criteria listed above are not met.
2. An electric lift mechanism is considered not medically necessary.