Education & Evidence /

Permobil Academy: Medicare Reimbursement for Wheelchair Seat Cushions and Backs: Coverage Criteria and Documentation

(2 hrs. / 0.2 CEUs)

General Overview: Clinical documentation for seating and wheeled mobility has come under rigorous scrutiny by Medicare and other funders, with stricter standards, a demand for clear and concise information, and inclusion of objective exam results to support what is being prescribed. Coverage criteria for these products are specific and often diagnosis driven. It is critical for the clinicians and providers to be familiar with eligibility and documentation requirements to ensure that each individual receives the most appropriate equipment. This course will review the Medicare coverage criteria for each type of wheelchair cushion and back support. It will also provide an overview of the documentation elements required for seating products and facilitate critical thinking regarding how to arrive at, present and report the information.

Objectives: By the end of the presentation, participants will be able to:

  1. Identify two ways how diagnosis-driven coverage criteria can impact access to clinically necessary equipment
  2. List the Medicare coverage criteria for each of the HCPCS codes for wheelchair seat cushions, back supports and pertinent positioning accessories
  3. Discuss two pros and two cons of different documentation formats
  4. List the objective information that should be included in documentation for skin protection and/or positioning product solutions, describe its importance and discuss how it should be reported.
  5. Discuss the type of information that should be included in the clinical justifications for wheelchair seating and identify the “should’s” and “should not’s”
  6. Identify one location to find information regarding Medicare’s equipment requirements and coverage criteria for seating products

See our upcoming onsite education courses at the Permobil Academy.

Share Button