Medicare Reimbursement for Power Wheelchairs and Scooters

Power mobility equipment offers a "new lease on life"specialist in Neurology, Rheumatology (arthritis),
to many persons with limited mobility. MedicareOrthopedic Surgeon, or Physiatrist (physical medicine).
reimburses power mobility equipment up to 80% of theScooters require more control of the trunk and the
Medicare allowable amount if the person qualifies forarm strength to operate the tiller.There are a few
this benefit and the health care professional certifiesother guidelines that are useful:1. Once Medicare had
that the wheelchair or scooter is medicallypaid for a power wheelchair or POV, they will not pay
necessary.Covering all of the Medicare regulations forfor a manual wheelchair. If the person has a manual
power mobility equipment could take up volumes. Onlywheelchair that is currently being rented by Medicare, it
mimimal information is included here. Some of thismust be returned to the Durable Medical Equipment
information I learned in training for my position as(DME) provider. If the chair has been paid by Medicare,
mobility specialist; other information I have gathered inthe wheelchair is property of the beneficiary. The
the past couple of years selling mobilitymanual wheelchair need not be returned in that case. If
equipment.Current Medicare guidelines for powerin doubt, contact the Regional Medical Equipent Carrier
wheelchairs require that:1. The person's condition isfor your region, or contact the DME company that
such that the person would be bed- or chair-confinedprovided the manual wheelchair.2. Medicare will not pay
without the use of a power wheelchair.2. The personfor a prosthesis once the person has a power
must need the power wheelchair use in the home.wheelchair. If the person is a recent amputee, the
Power mobility equipment that is needed only forperson must be fitted for and receive their prosthetic
convenience or for recreational purposes does notleg before Medicare will pay for power mobility
qualify for Medicare benefits. Certainly the person mayequipment.3. With similar rationale, Medicare will not pay
use the power wheelchair to go out; however, if that isfor walkers, or canes once they have paid for a
the only purpose for the power wheelchair, thepower wheelchair.Medicare regulations are always
equipment would not be an allowable charge.3. Thesubject to change. Indeed, an organization called
person cannot propel a manual wheelchair by him- orRAMP (Restore Access to Mobility Partnership) is
herself. Weakness or disability of upper extremitiescurrently lobbying for change in the Medicare laws that
(hands, arms, shoulders) must be present.4. Thewould ensure that those who need such equipment
person must demonstrate ability to safely operate thecan get it.For more information on power mobility
controls of the power wheelchair. Persons who mightequipment, check the Medicare web site.Kay Lowe
injure themselves or others while operating the powerMobility Specialist
wheelchair do not qualify for MedicareLowe holds a Master's Degree in Nursing and has
reimbursement.Regulations for scooters, or POVs30+ years in the health care field. She is currently
(power-operated vehicles) include the qualificationsemployed as mobility specialist.
above; however, the scooter must be prescribed by a