Medicare Criteria for "Power Scooters"
An individual who requires a power scooter usually cannot perform functional ambulation skills and has strength or use of the upper extremities. In addition, the patient should have adequate trunk stability to "hold" themselves upright in the seat. Medicare has certain coverage criteria to qualify a patient medically for a power scooter (E1230). A scooter would be considered medically necessary if all of the following coverage criteria are met:
- The patient's condition is such that a wheelchair is required for the patient to get around in the home, and
- The patient is unable to operate a manual wheelchair; and
- The patient is capable of safely operating the controls for the scooter, and
- The patient can transfer safely in and out of the scooter, and has adequate trunk stability to be able to safely ride the scooter.
Medical documentation needed:
A prescription from a specialist in physical medicine, orthopedic surgery, neurology or rheumatology stating "Power Scooter". (When such a specialist is not reasonably accessible, e.g. more than a day's round trip from the beneficiary's home, or the patient's condition preludes such travel, a prescription from the beneficiary's physician may be acceptable).
An order which has been signed and dated by the ordering physician and/or a certificate of medical necessity that has been filled out signed and dated.
TO SEE IF YOU QUALIFY FOR A POWER UNIT AND MEET MEDICARE'S GUIDELINES OR FOR ADDITIONAL INFORMATION, CALL US TODAY AT (800) 376-8267 or (425) 481-6546
