Most heath care insurance companies, including Medicare, have minimum requirements that need to be met before they will purchase a power chair for you. The patient is capable of safely operating the controls for the power wheelchair. 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. However, if the power wheelchair has been purchased, and the manual wheelchair on which payment is based is in the capped rental category, the power wheelchair will be denied as not medically necessary. Options that are beneficial primarily in allowing the patient to perform leisure or recreational activities are noncovered.
Payment is made for only one wheelchair at a time.
Backup chairs are denied as not medically necessary. One month' s rental of a wheelchair is covered if a patient-owned wheelchair is being repaired. Reimbursement for the wheelchair codes includes all labor charges involved in the assembly of the wheelchair and all covered additions or modifications. If you feel you meet these requirements, you may be eligible to receive the most stylish, best performing and most reliable power chair available on the market today. Pride Mobility Products Corp. All rights reserved.