Power Mobility Devices - Policy Article

Power mobility devices are payable under the DME benefit only when LCD reasonable-and-necessary criteria and statutory payment requirements are met, including a treating-practitioner face-to-face encounter and a Standard Written Order (SWO)/WOPD prior to delivery. Custom bases (HCPCS K0013) require detailed manufacturing and functional documentation; replacements within a five-year useful lifetime are limited to loss or irreparable damage, items for outside-home-only use and leisure-focused upgrades are noncovered, and specified Final Rule 1713 codes require a WOPD obtained before delivery.

"Power mobility devices (power wheelchairs and power-operated vehicles) are covered under the Durable Medical Equipment benefit when the reasonable-and-necessary requirements in the related Local Co..."

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