4 Steps to Medicare Coverage of a Power Mobility Device
Medicare Coverage Guidelines for POWER Mobility Devices:
4 Step Process Must Be Followed
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| Step 1 |
Visit with your physician for a face to face examination and discuss your mobility options. Medicare requires a face to face with your physician prior to writing a prescription for a power mobility device. Medicare requires a face to face with your physician prior to writing a prescription for a power mobility device.
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| Step 2 |
Have your physician fax or mail the written prescription and medical records to a mobility supplier in your area who accepts Medicare. The mobility supplier must receive the written prescription prior and supporting documentation (medical records) within 45 days from the date of your face to face examination.
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| Step 3 |
Your mobility supplier will conduct a home assessment to ensure that you have adequate access and maneuverability space. The primary reason for a power mobility device is to compensate for your mobility limitations within your home and your ability to perform activities of daily living. Therefore, it is critical to determine if your home environment will support the use of a scooter or power wheelchair.
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| Step 4 |
Your mobility supplier will order the power mobility device prescribed by your physician or treating practitioner. Delivery of the scooter or power wheelchair must be no more than 120 days following examination.
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Medicare may pay for a motorized wheelchair. Although it is not guaranteed that you will qualify or be reimbursed by Medicare, whether you personally lay out the price for one, or are looking for Medicare to purchase one for you, we can give you some guidelines to follow and the basic criteria that must be met in order for Medicare to either reimburse or authorize payment for a motorized unit. A power wheelchair is covered when all of the following criteria are met:
- The patient's condition is such that without the use of a wheelchair the patient would otherwise be bed or chair confined.
- The patient's condition is such that a wheelchair is medically necessary and the patient is unable to operate a wheelchair manually.
- The patient is capable of safely operating the controls for the power wheelchair.
A patient who requires a power wheelchair usually is totally non-ambulatory and has severe weakness of the upper extremities due to a neurological or muscular disease/condition. If the documentation does not support the medical necessity of a power wheelchair but does support the medical necessity of a manual wheelchair, payment is based on the allowance for the least costly medically appropriate alternative.
If you need more clarification or information just give us a call.
A&C Medical
203.262.1671
This Educational information has been provided by:
A&C Medical Equipment & Supplies Inc
Mobility Resource Center
385 Main Street South – Union Square
Southbury, CT 06488
203.262.1671- Showroom 203.262.1162 Fax
www.acmedical.com