If you haven’t already heard, Medicare and Medicaid have been shaking things up when it comes to the way claims for power mobility chairs are handled. CMS administrator Mark McClellan announced the initiative as far back as 2005 that is strengthening the agency’s policies for power mobility chairs. 
 

The three-prong approach starts with increased guidance regarding Medicare and Medicaid’s policy of power mobility chair coverage. Experts from throughout the Department of Health and Human Services have been called upon to further define and clarify conditions that currently meet CMS’ coverage guidelines as well as draft material that will help to better determine whether an individual meets those guidelines to receive a power chair. Also addressed in this area are ordering requirements which will be defined through laws that make certain parts of the Medicare Modernization Act (MMA) a reality.  
 

Secondly, the initiative takes a hard look at billing and payment, taking into consideration the long history of electric wheelchairs and Medicare. A newly-created nation-wide panel determines codes that do a better job of reflecting the wide variety of power mobility chairs on the market today.

Pride mobility power chairs represents just one of many companies that have expanded the number of power mobility chair models on the market, and thus, the needs for expanded and more accurate coding. In addition to the new CMS codes, the initiative creates accurate payment limits for each code. Up to the time of this initiative, the vast majority of power mobility chairs have been billed through the single K0011 code. 
 

The final part of the initiative requires suppliers to enroll in Medicare and meet strict quality guidelines. CMS has continued to review all supplier applications as they refer to electric wheelchairs and Medicare. The aim is to have suppliers not only meet government standards, but to also create a competitive bidding environment that brings the cost of power mobility chairs in-line with market rates. 
 

How this affects you and your mobility needs

Electric wheelchairs and Medicare have always been a hot and contested topic. While government does its best to make difficult choices that don’t always favor the mobility of the elderly and those with physical limitations, doctors are under increased burden in terms of documentation and face-to-face reviews to determine a patient’s true mobility needs.  
 

Even after what could be months of consultation with your doctor, specialists, suppliers and Medicare/Medicaid, the fate of someone who may legitimately need a mobility device is left in the hands of a regional CMS bureaucrat who will never meet you, but will review your paperwork to determine whether or not you qualify. 
 

As always, the best way to determine if you require a mobility device is to consult your doctor. They are the medical professional and know your history better than just about anybody. From there, you and our doctor can determine what steps are necessary to help you live a life of better mobility – whether it be through a power mobility chair or some other device. 
 

About The Author:
Daryl Clayton Kennedy is the editor and a regular contributor to disabled-mobility-scooter.com

See also

Medicare is a Federal Program and Often the Only Source of Health Insurance for the Elderly and Those with Permanent Disabilities. Medicare Coverage is Broken Into Four Parts: A, B, C and D...

Part B is one of the most important as it deals with durable medical equipment, which includes wheelchairs and scooters. Learn more...