17.3.14.1 Car Seats

All children must be transported as safely as possible. Children with breathing disorders, casts, neuromuscular deficits, or other health-care needs may need to use special needs car seats or travel restraints.

Providers supplying special-needs car seats must be CSHCN Services Program custom DME providers and must have received approved training from the manufacturer of the product requested. The comprehensive training must include correct use of car seats for children with special needs, and the proper installation of top tethers. Providers must demonstrate proficiency in the installation of the top tethers during this training. Installation of the top tether is essential for proper use of the car seat and is included in the reimbursement of the car seat.

Providers must keep a statement on record that is signed and dated by the child’s parent or guardian and the provider stating:

•	A manufacturer-trained provider has installed the top tether in the automobile in which the child will be transported.

•	A manufacturer-trained provider has trained the client’s parent(s) or guardian(s) in the correct use of the car seat.

•	The client’s parent(s) or guardian(s) has demonstrated the correct use of the car seat to a manufacturer-trained provider.

Prior Authorization Requirement for Car Seats

Requests for authorization of special-needs car seats must be submitted for medical review using procedure code E1399 (rental or purchase) and must include the following written documentation:

•	Providers must include the child’s weight and height (if the child weighs 40 pounds or is more than 40 inches in height, the actual height and weight must be provided).

•	Providers must include a description of the child’s postural condition, specifically including head and trunk control.

•	Providers must include the child’s expected long-term need for the car seat.

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A photocopy of the training certification of the individual installing the car seat must accompany each request for authorization to be considered for reimbursement by the CSHCN Services Program. Authorizations are not given to a provider until training is completed and the CSHCN Services Program claims contractor receives a copy of the training certificate.

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Providers must include the name of the individual installing the car seat on the form entitled, “CSHCN Services Program Prior Authorization and Authorization for Durable Medical Equipment (DME)” or providers must include documentation with the form indicating that the top tether was factory installed by the vehicle’s manufacturer before vehicle purchase.

•	Installation of the top tether is essential for proper use of the car seat and is included in reimbursement for the car seat. Providers may not bill the CSHCN Services Program for the installation of the top tether.

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Providers must keep a statement on record that is signed and dated by the child’s parent or guardian and the provider stating that a top tether was installed by a manufacturer-trained provider in the automobile used to transport the child; parent training in the correct use of the car seat was provided by a manufacturer-trained provider; and the parent demonstrated the correct use of the car seat to a manufacturer-trained provider.

The manufacturer’s weight limitation should be carefully considered when fitting the child for a car seat and should allow for at least 12 months of anticipated growth.

The CSHCN Services Program considers replacement after 7 years (normal useful life) or if a car is involved in an accident. (Some manufacturers may replace car seats at no cost following an accident, if a police report from the accident is provided.)

Car seat accessories for correct positioning, available from the manufacturers, may be authorized when medically necessary. Only car seat modifications and accessories that have been crash-tested with the car seat and provided by the manufacturer of the car seat may be authorized.