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What are the Cms Documentation Requirements for Complex Rehab?

To secure funding for complex rehab technology, you must assemble a comprehensive documentation package that proves medical necessity. Key requirements include:

  • A detailed face-to-face mobility evaluation completed within the past six months.
  • A 7-element order signed by your physician, which must include patient and device information, diagnosis, prognosis, duration of need, quantity, and the physician’s signature.
  • A detailed Letter of Medical Necessity (LMN) that explains your diagnosis and justifies why a standard wheelchair or basic equipment is insufficient for your needs.
  • A functional mobility assessment conducted by a licensed therapist or a RESNA-certified Assistive Technology Professional (ATP).
  • A comprehensive product description that links specific custom components and power features—such as tilt, recline, or specialized seating—to your clinical functional limitations.
  • Any required insurer-specific forms, such as those for Medicare power wheelchair prior authorization, and proof of delivery once the equipment is received.

MedEquipped assists in this process by auditing these documents for completeness, ensuring that all records align with clinical standards and payer requirements to minimize delays or denials.

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