Dose patient need wheelchairs?

Manual Wheelchairs

Manual wheelchairs may be considered medically necessary if the patient meets the basic criteria for a wheelchair.

Rollabout chairs and transport chairs may be considered medically necessary when used in place of a wheelchair for those who qualify for a wheelchair.

A manual wheelchair is considered not medically necessary:

• If the patient is able to safely walk with a cane or a walker a distance that would allow access to all necessary rooms in their home and allow them to perform their activities of daily living
• If the manual wheelchair is only for use outside the home

Electric, Power or Motorized Wheelchairs

Power wheelchairs may be considered medically necessary if the patient meets the basic criteria for a wheelchair and is unable to operate a manual wheelchair.

Documentation must include:

• The medical necessity for the power wheelchair.
• Information that the patient lacks the upper extremity strength to propel the wheels of a manual wheelchair or that the patient’s medical condition does not allow the patient to self-propel a manual wheelchair.
• Information that the patient is capable of safe operation of the controls of a power wheelchair.