Mobility Assistive Devices (Wheelchairs) - MEDICAID - VIRGINIA

This Humana Medicaid (VA) medical coverage policy defines medical necessity criteria for wheelchairs, power wheelchairs, complex rehabilitative power-driven wheelchairs, pediatric wheelchair modifications, wheelchair management (97542), and specific wheelchair accessories. Coverage requires a licensed provider order and, for many complex items, specialty evaluations and home assessments documenting medical necessity; numerous specific accessories and technologies and duplicate equipment are expressly excluded, and repairs/replacements are subject to warranty, functional need, and reasonable useful lifetime (generally 5 years).

"Wheel braking system and lock (manual wheelchair accessory); (E2228);"

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