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Scooter - Medicare Requirements Checklist

Medicare Billing for Scooters

Atlantic Healthcare Products is a durable medical equipment (DME) provider. We are experienced in Medicare billing and take care of all the paperwork for our patients in Palm Beach County.We work closely with patients, their doctors, and Medicare to make sure everyone is on the same page and that our patients can get the supplies they need. Contact us today if you or a loved one needs help with Medicare billing for scooters or any other DME needs. 

Criteria and Medical Justification must be met for coverage.

Save time by filling out our basic patient information form. All we need is patient name, date of birth, contact information, address, insurance information and a brief description of what you are looking for.  Once we receive your information, we will get the process started before you get to the store.  Click on Get Pre-Qualified below to get started.

The checklist below is derived from Medicare’s Coverage criteria for a Scooter (POV). Without the below criteria being fully and legible documented in the physician's chart notes and Rx, Medical justification has not been met.


Patient Medicare Requirements

Scooter Documentation Requirements for Medicare

Checklist for Face-to-Face Examination Chart Notes for a Scooter (POV)  

 

Do the Medical records relevant to mobility needs 1) indicate and 2) support: 

Reason: ‘Mobility evaluation for a: Powered Mobility Device, PMD, Scooter or POV

▢ Any other reason, or “follow-up” is not acceptable

 History of present condition and relevant past medical history:

▢ Symptoms that limit ambulation

▢ Diagnoses that are responsible for symptoms

▢ Medications or other treatment for symptoms

▢ Progression of ambulation difficulty over time

▢ Distance beneficiary can walk without stopping

▢ Pace of ambulation

▢ History of falls, including frequency, circumstances leading to falls

Physical examination relevant to mobility needs:

▢ Height and weight

▢ Cardiopulmonary examination

▢ Arm and leg strength tests and range of motion tests. 

Neurological examination:

▢ Gait

▢ Balance and coordination

Mobility Assessment

▢ Description of the mobility limitations and how it impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADLs) such as toileting, feeding, dressing, grooming, and bathing in customary locations in the home.

- AND -  

▢ prevents the beneficiary from accomplishing an MRADL entirely;  - or - 

▢ places beneficiary at a reasonably determined risk secondary to the attempts to perform an MRADL;  - or – 

▢ prevents beneficiary from completing an MRADL within a reasonable amount of time

▢ Beneficiary’s mobility limitation cannot be sufficiently and safely resolved by use of appropriately fitted cane or walker;

- AND -  

▢ Beneficiary does not have sufficient upper extremity function to self-propel an optimally configured manual wheelchair in the home 

- AND -  

▢ Limitations of strength, endurance, range of motion, or coordination, presence of pain, or deformity or absence of one or both upper extremities; 

- AND -  

▢ Beneficiary’s mental capabilities (e.g., cognition, judgment) and physical capabilities (e.g., vision) are sufficient for safe mobility; -- Beneficiary’s weight is less than or equal to weight capacity of scooter provided; 

- AND -  

▢ Beneficiary’s home provides adequate access; or differ to Provider’s Home Assessment  

- AND -  

▢ Use of a Scooter POV will significantly improve the beneficiary's ability to participate in MRADLs and beneficiary will use it in the home.; 

- AND -  

▢ Beneficiary has not expressed an unwillingness to use a PWC in the home. 

7 Element Order

▢ beneficiary's name, 

▢ item of DME ordered “SCooter”, “POV”, or Power Mobility Device 

▢ Length of Need. 

▢ Date of the Face to Face Examination

▢ Date of the order 

▢ Diagnosis or Dx Code

▢ Legible Signature of the ordering practitioner, or signed over printed name. 

Statutory Timing Requirements

▢ Did the Supplier Receive within 45 days the 7 Element Order. 

▢ Did the Supplier Receive within 45 days the F2F Examination Report. 

▢ Will Delivery of the Power Wheelchair be before 120 days after the F2F

Please fax your referrals and documentation to 561-290-1434 


Need a Scooter Today?

We have scooters available to purchase or rent.  We have a variety of Scooters to Purchase, look online or visit one of our locations . If you are not ready to purchase, not sure if this is the right medical equipment for you, or just need it for a short period of time, we also have Rental Scooters available.  

How do I get a Scooter through Medicare?

DME, or durable medical equipment, can be essential for those with mobility issues. Medicare will often cover the cost of DME, but the process of billing can be complex. At Atlantic Healthcare Products, we have experience with Medicare billing for scooters. We will work with you, your doctor, and Medicare to make sure that all coverage criteria are met. We can also deliver the scooter directly to your home in Eastern Palm Beach County. Contact us today to learn more about how we can help you get the DME you need.

We can be reached by chat, phone or just visit us at one of locations.

West Palm Beach: 561-964-6767

Boynton Beach: 561-733-2331

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