NCDActive
INDEPENDENCE iBOT 4000 Mobility System
NCD317
Effective: July 26, 2006
Updated: December 31, 2025
Policy Summary
CMS covers the INDEPENDENCE iBOT 4000 only when configured for the Standard Function as DME for beneficiaries with a personal mobility deficit that impairs participation in MRADLs in customary locations in the home; determination of deficit must follow the algorithm in Medicare Benefit Policy Manual (Ch.1, Pt.4, §280.3). The 4-Wheel, Balance, Stair, and Remote Functions are nationally non-covered and do not meet the definition of DME.
Coverage Criteria Preview
Key requirements from the full policy
"The INDEPENDENCE iBOT 4000 Standard Function is covered as DME for beneficiaries with a personal mobility deficit sufficient to impair participation in mobility-related activities of daily living (..."
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