As of 7/1/2013 Medicare instituted a competitive bid program on these items, and strictly limits what providers can and cannot provide these to Medicare Patients. Unfortunately we did not win a bid, and no longer bill Medicare for wheelchairs. To find a provider in your area Click Here and follow the instructions
Since the amount that Medicare will pay was significantly reduced, we would advice that you ask the provider to let you know the type of wheelchair you will be receiving, along with brand name and model number. It is important that the walker still meets your needs.
Click Here to see some of the wheelchairs we have available to you. We have a large retail show room where you can see and try the product. We rent and sell wheelchairs.
Transport Chairs start at $160.00
Standard Wheelchairs start at $295.00
Q: What is a needed for Medicare coverage?
A: A prescription from your doctor with a qualifying diagnosis.*
New for 2011 We also need detailed chart notes detailing the need for the use of the chair within the home
In order to qualify the chart notes/medical record must show that the patient has a significant limitation in their Mobility Related Activities of Daily Living (MRADL's) MRADL's are activities such as bathing, going to the bathroom, eating, dressing ect.
The chart notes must also include why other mobility equipment like a walker or cane would not be sufficient.
A letter or a prescription are different from medical records/chart notes, and alone do not qualify you for to receive and equipment.
How to Order
Come to the store and pick out a wheelchair. You may also call us for more information.
Medicare offers a 13-month rent-to-own program for patients who have not previously owned a wheelchair.* If the patient has a wheelchair and goes to a hospital, rehab center, nursing home, or hospice care, we must be notified, as the wheelchair will no longer be covered.
If you require a wheelchair larger than the standard size, we must be presented with the patient’s height and weight.
*Please note these are general outlines for coverage and we cannot guarantee coverage until claims are submitted and paid.
Official Medicare Guidelines
Manual Wheelchairs – Coverage Criteria Physician Documentation Requirements Manual wheelchairs are covered by Medicare when a patient is unable to adequately ambulate within their home to accomplish their activities of daily living even with the assistance of a cane, crutch, or walker. The medical necessity for the wheelchair must be clearly documented in the patient’s medical records. The records could include your office notes, hospital records (e.g., operative note or discharge summary), or the records of other healthcare professionals (e.g., physical therapist or occupational therapist). The records must indicate the diagnoses that are related to the need for the wheelchair and pertinent history including: symptoms that limit ambulation, progression of the disease and ambulatory difficulty over time, experience with a cane or walker and why it isn’t sufficient. It should specifically describe how far the patient is able to ambulate without stopping and with what assistive device. There must be a physical examination, including (as applicable): leg strength, range of motion, presence of contracture or spasticity, balance and coordination, cardiopulmonary exam, etc. The evaluation should also include documented observation of ambulation with use of a cane or walker, if appropriate. Simply listing this information on the order or on a form provided by the supplier is not sufficient. It must be documented in the patient’s medical records. It is important to keep in mind that because of the way that the Social Security Act defines durable medical equipment, a wheelchair is covered by Medicare only if the beneficiary has a mobility limitation that significantly impairs his/her ability to perform activities of daily living within the home. If the wheelchair is needed in the home, the beneficiary may also use it outside the home. However, in your evaluation you must clearly distinguish your patient’s mobility needs within the home from their needs outside the home. A standard manual wheelchair can be covered if the patient cannot self-propel the wheelchair but has a caregiver who is able to assist. However, if a lightweight, high strength lightweight, or ultralightweight wheelchair is being ordered, there must be documentation that the patient has sufficient arm strength to self-propel that chair as well as information concerning approximately how many hours per day the patient will spend in the wheelchair and the extent of the activities that he/she can perform. Lighter weight wheelchairs are not covered solely for the benefit of the caregiver.
There must be a detailed written order that lists the specific type of wheelchair that is being ordered, including all separately billable options and accessories. It should list the length of need for the wheelchair. This document may be prepared by the supplier, but you must review it, initial and date any changes, and then personally sign and date the order. Signature and date stamps are not acceptable. Verbal orders are not sufficient for Medicare coverage. Physicians can view the complete local coverage determination and policy article titled Manual Wheelchairs on the National Government Services Web site at www.NGSMedicare.com. It may also be viewed in the local coverage section of the Medicare Coverage Database at www.cms.hhs.gov/mcd/search.asp Suppliers may ask you to provide the documentation from your medical records on a routine basis in order to assure that Medicare will pay for these drugs and that your patient will not be held financially liable. Providing this documentation is in compliance with the Health Insurance Portability and Accountability Act Privacy Rule. No specific authorization is required from your patient. Also note that you may not charge the supplier or the beneficiary to provide this information. Please cooperate with the supplier so that they can provide the wheelchair that is needed by your patient.