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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say that a power seat elevation feature (E2300) and power standing feature (E2301) are non-covered 
because they are not primarily medical in nature. If a wheelchair has an electrical connection device described 
by code E2310 or E2311 and if the sole function of the connection is for a power seat elevation or power 
standing feature, it will be denied as non-covered. 
 
An electronic interface used to control lights or other electrical devices is non-covered because it is not 
primarily medical in nature. 
 
A harness (E2313) describes all of the wires, fuse boxes, fuses, circuits, switches, etc. that are required for the 
operation of an expandable controller. It also includes all the necessary fasteners, connectors, and mounting 
hardware. Code E2313 is separately billable in addition to an expandable controller both at initial issue and 
with complete replacement of the expandable controller. Code K0108 must not be used for any component or 
feature of an expandable controller at the time of initial issue. The reimbursement for any type of complete 
expandable controller is included in the allowance for codes E2377/E2376 plus E2313. However, if individual 
components of the harness are replaced, code K0108 should be used 
 
The interfaces described by codes E2312, E2321, E2322, E2325, E2327, E2328, E2329, E2330, E2373, E2374, 
E2375, E2376, E2377 must have programmable control parameters for speed adjustment, tremor dampening, 
acceleration control, and braking. 
 
A remote joystick is one in which the joystick is in one box that is typically mounted on the arm of the 
wheelchair and the controller electronics are located in a different box that is typically located under the seat of 
the wheelchair. The joystick is connected to the controller through a low power wire harness. A remote joystick 
may be used for either hand control, chin control, or attendant control. 
 A standard proportional remote joystick is one which requires approximately 340 grams of force to activate, 
and which has an excursion (length of throw) of approximately 25 mm from neutral position. It can be used 
with a non-expandable or an expandable controller. There is no separate billing for a standard proportional 
remote joystick when it is provided at the time of initial issue of a power wheelchair whether it is used for hand 
or chin control by the beneficiary or whether it is used as an attendant control in place of a beneficiary-operated 
drive control interface. 
 
Codes E2374, E2375, E2376 describe components of drive control systems. They may only be used for 
replacements other than at the time of initial issue. 
 
Code K0108 is appropriately used at the time of initial issue only when the drive control interface that is 
provided is not included in the base code and there is no specific E code which describes it. K0108 must not be 
used for additional features of a joystick. 
 
Code K0108 is appropriately used at the time of replacement in the following situations: 
 
        An integrated proportional joystick and controller box are being replaced due to damage; or 
 
        An interface other than a remote joystick (e.g. sip and puff, head control) is being replaced but the 
controller is not being replaced; or 
 
        There is no specific E code which describes the type of drive control interface system which is provided. 
 
You can find this rule in the Local Coverage Article Wheelchair Options/Accessories - Policy Article A52504. 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com. 
 
The Plan contract says that the Plan covers items and services in accordance with Medicare rules.