DecisionHealth, DecisionHealth - 2004 Issue 2 (February)
Power wheel chairs: You must schedule a visit before prescribing ,
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Article Overview
This article discusses a Medicare policy change affecting power wheelchairs and power-operated vehicles, with emphasis on the need for a prior face-to-face examination, documentation handling, and supplier/physician recordkeeping responsibilities. It is aimed at physicians and other prescribers, as well as DME suppliers and billing staff who need to understand the compliance implications and associated medical necessity paperwork. The article also references CMS and DMERC guidance in the context of documentation requests and reimbursement oversight.
Why This Topic Matters
It helps readers recognize a compliance-sensitive area of DME prescribing where missing documentation or incomplete medical necessity paperwork can create payment and liability risk.
Article Sections
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Face-to-face visit requirement before prescribing
Overview of the new Medicare requirement for an in-person evaluation before issuing a prescription for a powered mobility item. The section frames the policy change and its effect on prescribers.
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Documentation and CMN responsibilities
Discussion of recordkeeping expectations, certificate of medical necessity handling, and the role of documentation in supporting the medical record. The section also notes the involvement of suppliers and Medicare contractors in oversight.
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Excerpted statutory language
Quoted legislative language describing the Medicare payment standard for powered wheelchairs and related prescriber qualifications. The section reproduces the statutory excerpt referenced by the article.
What You Will Learn
- What Medicare requires before prescribing a powered mobility item
- How documentation responsibilities are divided among the parties involved
- Why medical necessity records may be requested in review or audit situations
- Which types of clinicians are referenced in the policy language
Who Should Read This
- Physicians
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- DME suppliers
- Medical coders and billers
- Compliance staff
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