Scooters

Power Operated Vehicles (POVs)/Scooters

Medicare

has modernized the policy and replaced the Bed or Chair Confinment requirements with consideration now given to the beneficiary's ability to safely and in a reasonable time fream participate in one or more Mobility Related Activities of Daily Living (MRADLs).

A face-to-face examination with your referring physician is required prior to any PMD being prescribed.

Medicare looks for the following information from your physician:

Face-to-face examination:

The report of the face-to-face examination (see Policy Article) should provide information relating to the following questions: (each one has to be addressed in the chart notes!!!!)

1. What is this patient's mobility limitation and how does it interfere with the performance of activities of daily living?
2. Why can't a cane or walker meet this patient's mobility needs in the home?
3. Why can't a manual wheelchair meet this patient's mobility needs in the home?
4. Does this patient have the physical and mental abilities to operate a POV (scooter) safely in the home?

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The Physician also has to address the above AND

1. Does the patient have the physical and mental abilities to operate a power wheelchair in the home?

Lift Chairs

Medicare Coverage Criteria Lift Chairs

A seat lift mechanism is covered if all of the following criteria are met:

1.  The patient must have severe arthritis of the hip or knee or have a severe neuromuscular disease.

2.  The seat lift mechanism must be a part of the physician's course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the patient's condition.

3.  The patient must be completely incapable of standing up from a regular armchair or any chair in their home. (The fact that a patient has difficulty or is even incapable of getting up from a chair, particularly a low chair, is not sufficient justification for a seat lift mechanism. Almost all patients who are capable of ambulating can get out of an ordinary chair if the seat height is appropriate and the chair has arms.)

4.  Once standing, the patient must have the ability to ambulate.

Coverage is limited to the seat lift mechanism, even if it is incorporated into a chair.

Related Web Site Links

The Centers for Medicare & Medicaid Services (CMS) http://cms.hhs.gov

Region A DMERC www.umd.nycpic.com/dmrmrp.html

Region B DMERC www.astar-federal.com

Region C DMERC www.pgba.com

Region D DMERC www.cignamedicare.com

Official US Government Site for Medicare Information   www.medicare.gov

Medicare HMO - www.medicarehmo.com

WebMD - www.webmd.com

AARP - www.aarp.org

Social Security Administration - www.ssa.gov