MEDICARE FACTS FOR MOBILITY SCOOTERS
PMD- Power Mobility Devices are regulated by CMS - Centers for Medicare and Medicaid Services using specific guidelines to determine medical necessity of any mobility scooter or power chair. Most of the power mobility devices are delivered by an In Network Medicare contractor that has accepted a bidding contract and predetermined cost. Mobility Express Lakeland has opted out of working for CMS in providing Power Mobility Devices due to extremely low reimbursement fees. The first step is talking to your Primary Care Physician and getting a prescription for the Power Mobility Device.
In addition to the prescription for the PMD, the physician or treating practitioner must provide the supplier with supporting documentation consisting of portions of the medical record essential for supporting the medical necessity for the PMD in the beneficiary's home. In order to document the need for a PMD there are a few specific statutory requirements that must be met before the prescription is written:
- An in-person visit between the ordering physician and the beneficiary must occur. This visit must document the decision to prescribe a PMD.
- A medical evaluation must be performed by the ordering physician. The evaluation must clearly document the patient's functional status with attention to conditions affecting the beneficiary's mobility and their ability to perform activities of daily living within the home. This may be done all or in part by the ordering physician. If all or some of the medical examination is completed by another medical professional, the ordering physician must sign off on the report and incorporate it into their records.
- Items 1 and 2 together are referred to as the face-to-face exam. Only after the face-to-face examination is completed may the prescribing physician write the prescription for a PMD. This prescription has seven required elements and is referred to as the seven-element order which must be entered on the prescription only by the physician.
- The records of the face-to-face examination and the seven-element
order must be forwarded to the PMD supplier within 45 days of the completion of the face-to-face examination 5. CMS' National Coverage Determination requires consideration as to what other items of mobility equipment (MAE), e.g., canes, walkers, manual wheelchair, etc., might be used to resolve the beneficiaries mobility deficits. Information addressing MAE alternatives must be included in the face-to-face medical evaluation
So basically Medicare considers Power Mobility Devices as a medical necessity for in home use only for the patient to get to the bathroom to toilet and the kitchen to eat. Unfortunately, most people want to use a mobility scooter for outdoor activities such as grocery shopping, theme parks and getting around the neighborhood.
Follow this link here for more information: Click Here For CMS PMD Website