To obtain a Medicare-approved power wheelchair, you must complete a multi-step clinical evaluation process involving both a physician and specialized mobility professionals:
- Face-to-Face Physician Evaluation: You must first visit your doctor for an in-person examination. During this visit, the physician must document your physical condition (such as severe arthritis or neurological disorders) and explain why you cannot effectively use a cane, walker, or manual wheelchair for daily activities inside your home.
- Assistive Technology Professional (ATP) Evaluation: For more advanced equipment, such as Group 2 or Group 3 power wheelchairs, a certified ATP must conduct a thorough mobility assessment. They use standardized tools like the Wheelchair Skills Test to evaluate how you navigate your environment and identify specific functional limitations to ensure the device is configured for an optimal fit.
- Home Assessment: An evaluation of your living space is required to ensure the power wheelchair can navigate your rooms and hallways effectively. Providers like MedEquipped often handle these assessments as part of the coordination process.
Following these evaluations, your physician must provide a written order and sign the necessary CMS documentation to establish medical necessity for the equipment.
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