- 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.