Policy brief: adaptive cycling equipment for individuals with neurodevelopmental disabilities as durable medical equipment

Abstract

- Durable medical equipment (DME) policies require that the equipment be medically necessary; however, adaptive cycling equipment (bicycles and tricycles) are usually not deemed medically necessary.- Individuals with neurodevelopmental disabilities (NDD) are at high risk for secondary conditions, both physical and mental, that can be mitigated by increasing physical activity.- Significant financial costs are associated with the management of secondary conditions.- Adaptive cycling can provide improved physical health of individuals with NDD potentially reducing costs of comorbidities.- Expanding DME policies to include adaptive cycling equipment for qualifying individuals with NDD can increase access to equipment.- Regulations to ensure eligibility, proper fitting, prescription, and training can optimize health and wellbeing.- Programs for recycling or repurposing of equipment are warranted to optimize resources.

An Important Tool to Understand Durable Medical Equipment and Supply Use in Children

“…Additionally, needed DMES are sometimes obtained through means not captured in claims, eg, lending agencies, out-of-pocket purchases, or do-it-yourself (or build-it-yourself) workarounds. At times, DME is obtained through home and community-based waiver programs, including for items that may not yet have HCPCS codes . Many of these limitations illustrate the value and potential utility of the authors’ system.…”

“…At times, DME is obtained through home and community-based waiver programs, including for items that may not yet have HCPCS codes. 3,8 Many of these limitations illustrate the value and potential utility of the authors' system.…”