Documenting medical need for custom seating… part three

The Ride Custom Back’s multi-axial hardware is highly adjustable to help optimize stability and postural alignment (overhead view).

In our last post, we discussed documenting the need for a custom wheelchair back or cushion vs. a prefabricated back or cushion.  Here, we continue the documentation discussion…

Part Three

Less Costly Alternatives?

Funding sources, including Medicare, expect clinicians to document the reason one custom product is selected over others that may be less costly.  Here are some of the differentiating reasons that Ride Custom 2 Cushions and Ride Custom Backs may be selected over other custom cushions and backs.

Ride Custom Cushion:

• Unlike other custom-molded wheelchair cushions, Ride’s patented and evidence-based mechanism of support helps to enhance sitting stability and performance, while reducing the dangerous forces of pressure and shear from at-risk bony prominences. Jane’s inability to perform a functional weight shift places her at high risk for pressure injuries, and the design of the Ride Custom 2 Cushion is critical to maintaining her skin integrity.

• Unlike other custom-molded wheelchair cushions, the Ride Custom 2 Cushion is modifiable in the field, without factory intervention or cost, to accommodate changes in Jane’s pelvic presentation over time.

• Unlike other custom-molded cushions, the Ride Custom 2 Cushion manages heat and moisture and can be cleaned and sanitized to provide a healthy microenvironment. This is critical for Jane Doe as she resides in a warm, humid client, and is at risk for pressure injuries.

Ride Custom Back:

• Unlike other custom-molded backs, the Ride Custom Back has a thin profile and multi-axial hardware which enables precise adjustment of lateral orientation to bring the head and neck to midline over supported residual scoliosis.  Jane requires the thin profile to maximize upper extremity range of motion and function, and requires the multi-axial hardware to adjust the position of the back to optimize her stability and postural alignment.

• Unlike other custom-molded backs, the Ride Custom Back manages heat and moisture, and can be cleaned and sanitized to provide a healthy microenvironment.  Jane’s warm and humid environment make this medically necessary.

If you need assistance with documentation review for your Ride Custom Back and/or Cushion order, we can help, and at no cost to you!  Contact our Reimbursement Department at (866) 781-1633 x 312.

Documenting medical need for custom seating… part two

The Ride Custom 2 Cushion is made specifically to match each individual’s unique shape to help decrease long-term skin risk and aid in sitting stability for improved functional performance.

In our last post, we discussed Medicare’s documentation requirements for custom wheelchair backs and cushions.  Here we continue the series…

Part Two

In the written therapy evaluation — why Ride Custom over prefabricated cushions and backs?

The beneficiary may present with: specific body measurements, significant postural deviations, contractures, pelvic tilt, obliquity, rotation, etc. that cannot be accommodated by a prefabricated cushion or back. 

These presentations should be well documented to demonstrate the reason a prefabricated cushion or back will not provide sufficient skin protection and/or postural support.  Documented trial and failure of lower level equipment is beneficial.

Example:  Jane Doe presents with a very pronounced anterior pelvic tilt, a left pelvic obliquity, a left lumbar convex scoliosis, a right convex thoracic scoliosis, a marked thoracic kyphosis, and a forward head. Her lower extremities assume a position of abduction. Her legs exhibit a leg length discrepancy with the right lower extremity being shorter than the left. 

There are no prefabricated wheelchair cushions that will accommodate these postural deviations to provide sufficient stability and pressure management. There are no prefabricated backs that will provide accurate contour to accommodate and support Jane’s posture. 

With lack of sufficient pelvic and trunk support, Jane is at risk for developing progressively more severe postural asymmetries as well as pressure injuries. In addition, a poorly fitting prefabricated seating system will severely limit Jane’s ability to independently perform mobility-related activities of daily living. 

A Ride Custom 2 Cushion and Ride Custom Back will be made specifically to match Jane’s complex shape, helping to decrease long-term skin risk and aiding in sitting stability for improved functional performance.

Continue reading, go to part three.

If you need assistance with documentation review for your Ride Custom Back and/or Cushion order, we can help, and at no cost to you!  Contact our Reimbursement Department at (866) 781-1633 x 312.


Documenting medical need for custom seating… part one

Ride Custom Cushion and Back made for a pediatric client.

Navigating the U.S. Medicare guidelines for documenting the medical need for custom seating can seem daunting.  We’ll break it down for you here.

Part One

To start, Medicare requires that a beneficiary needing custom seating is seen by a Physical or Occupational Therapist to evaluate the seating needs, in addition to a physician. The documentation generated by the physician and therapist will need to contain three primary pieces of information:

  1. The beneficiary meets Medicare’s coverage criteria for the wheelchair on which the seating will be installed.
  2. The beneficiary’s condition and diagnosis meet Medicare’s criteria for custom seating. Specifically:
    1. For custom backs – there are documented, significant postural asymmetries that are the result of a qualifying diagnosis.
    2. For custom cushions – there is a documented, current pressure ulcer or history of pressure ulcer on the lower back, sacrum, hip or buttock, OR documented absent/impaired sensation in these same areas, OR documented inability to perform a functional weight shift, as the result of a qualifying diagnosis.
  3. A statement clearly explaining why a prefabricated seating system will not sufficiently meet the medical need of the beneficiary. (This piece of information cannot come from the physician alone, it must be in the written therapy evaluation).

Continue reading, go to Part Two!

If you need assistance with documentation review for your Ride Custom Back and/or Cushion order, we can help, and at no cost to you.  Simply contact our Reimbursement Department at (866) 781-1633 x 312.

Precisely formed: Custom Backs

Ride Custom Back forming process

Ever wonder how the Ride Custom Back is made? Check out this video…

Hot, high-grade prosthetic plastic is vacuum-formed to a specific client’s back shape. The shell provides stability and is the outermost layer that hardware will mount to. Once the shell cools, Ride technicians will cut the back out and begin adding the materials necessary for breathability and comfort. It’s just one part of the process involved in delivering the best custom products available to wheelchair seating users.

Why you should come to Colorado for the Ride Custom Certification Course…


This course is designed specifically for clinicians and suppliers who want to take their seating skills to the next level.

We’re often asked if we will have a certification course outside of Denver. While this is an option that is continually being discussed, we believe traveling to Colorado is still the very best option for getting the most out of the Ride Custom Certification Course.

“Most practical, clearly explained and in-depth seating workshop I have participated in, in my nine years in the industry. Love the culture of the company.”

The two-day course will provide you with the best information available on custom seating — course content ranges from dynamic lecture session to hands on workshop sessions.


We stress working as a team to get the best outcome, from clinicians, to ATPs, techs and the clients themselves. Ride takes the same approach to our seating courses — our lineup of presenters and hands-on facilitators are among the best in the industry. We offer our stellar seating experts in presentations from Tom Hetzel, PT, Ride Designs CEO, and in hands-on guidance from founder and president, Joe Bieganek.

Part of what makes the class unique is that you’ll get to interact and work with a significant number of people on the Ride Designs team. You’ll tour the Aspen Seating Clinic and the Ride manufacturing facility for a better understanding of how the product line has evolved, been produced, and tested.

“Excellent opportunity to tour the production facility and now truly appreciate the technology, training and time that goes into the creation of the Ride cushions. Appreciated the review of the evidence to support technology and help bolster my clinical justification.”


The course begins with an in-depth lecture on seating theory. We discuss why Ride’s seating strategy is based on science developed by prosthetists and orthotists. We consider the benefits of pressure and shear, yes, you read that right, benefits of pressure and shear. There’ll be discussions on the research relevant to Ride products. We’ll also discuss early and late seating strategies/interventions, based on different postural tendencies along with handling unique body postures. These sessions will reveal the differences between Ride Designs and the other players in the seating industry.

The orthotic and prosthetic approach to seating is quite different from the philosophy of every other seating company. Our goal is to arm you with the best tools for successful outcomes with custom seating. Every Certification class provides individualized attention and hands-on experience with actual wheelchair users who are dealing with real-life seating challenges.


“Finally, a seating course for experienced clinicians with amazing supportive research, wonderful educators and an abundance of take home knowledge. I’m excited to share with our rehab team!”

You’ll also get to network with a group of cool people from the industry in a relaxed setting. (Did we mention the food?!) You’ll gain CEUs and be certified to work with our custom products… perhaps you can even tack a couple of days onto your trip to spend some time exploring Colorado! Pick a date and plan a trip — registration is open here!

[And yes, the quotes above are actual verbatim comments from attendee evaluations.]