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Does Medicare Cover Motorized or Power Wheelchairs / Chairs?

Medicare will pay for a motorized wheelchair 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. 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 not covered.

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