Pediatric Gait Trainers - DME.WC.104.A

Pediatric gait trainers (HCPCS E8000–E8002) are covered as medically necessary only for individuals ≤18 years with neuromuscular injury/disease who require assistance to walk; devices for >18 or situations not meeting all criteria are excluded. Key requirements: documented age ≤18, clinical evidence that crutches/less restrictive aids failed, a trial showing the gait trainer enables standing and stepping, planned use with an exercise/therapy program, correct HCPCS coding, and adherence to the member’s health plan/prior‑authorization rules.

"A pediatric gait trainer (HCPCS E8000-E8002) is medically necessary for an individual (≤ 18 years of age) when all of the following conditions are present:"

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