Manual Wheelchair
Manual Wheelchair Coverage
Ohio Medicaid:
A manual wheelchair may be covered if:
- The patient would be otherwise confined to stationary position for all but very brief periods of ambulation. They are covered in the home. In a long term care facility, only wheelchairs with custom seating are covered
- Chairs for children under the age of 1 year will not be approved.
- Chairs for leisure or recreational activities are not considered medically necessary and will not be approved.
- Documentation: A one page CMN is required for standard wheelchairs (a six page CMN is required for powered mobility or any W/C with custom seating) with no seating. Prior authorization is not required for short-term rentals (up to 4 months) of standard, standard hemi and lightweight wheelchairs. Prior authorization is required for other manual wheelchairs, long term rentals and any wheelchairs.
Medicare:
A manual wheelchair may be covered if:
- The beneficiary has a mobility limitation that significantly impairs his/her abilities to participate in one or more Mobility Related Activities of Daily Living (MRABL’s) in the home (toileting, feeding, dressing, grooming and bathing). A mobility limitation is one that prevents one from accomplishing MRADLs, or causes a heightened risk of illness/injury or death secondary to the attempts to participate in MRALs, or prevents one from completing MRADLs within a reasonable time frame. In addition, equipment may be covered if other conditions limit the ability to participate in MRADLs (e.g., impaired cognition or vision).
- The beneficiary/caregiver is able to use the equipment safely.
- A walker or cane is not sufficient.
- The home environment must be able to support the use of the equipment.
- Physician chart notes and/or a PT/OT assessment documents: The beneficiary’s medical history including use of other equipment, mobility limitations and ability to operate equipment, mobility limitations and ability to operate equipment safely must be documented.
Contact Us Online for a FREE Mobility Consultation or Call Us at (800) 762-5438
