Item Covered Denied CMN SOP Item Information
• Motorized Wheelchair

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Power wheelchairs are covered when the following criteria are met:

  • Patient's condition is such that without the use of a wheelchair he/she would otherwise be bed or chair confined, and
  • Patient's condition is such that a wheelchair is medically necessary and the patient is unable to operate a wheelchair manually around in their residence, and
  • The patient has severe weakness of the upper extremeties, due to neurological, muscular or cardiopulmonay disease/condition
  • The patient is unable to operate any type of manual wheelchair, and
  • The patient is able to safely operate the controls of a power wheelchair, and
  • Medicare has not rented or purchased a manual wheelchair for this patient.

Custom power wheelchairs are covered for patients requiring a uniquely constructed wheelchair. The wheelchair is covered only if the feature needed is not available in an already manufactured wheelchair or component to a wheelchair. There has to be customization to the wheelchair frame to be considered customized.

Accessories:

Check with a MedOne Healthcare customer service representative on all wheelchair accessories and reimbursement.