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Power Mobility Device Provision: Understanding Medicare Guidelines and Advocating for Clients

Dicianno, BE and Tovey, E (2007) Power Mobility Device Provision: Understanding Medicare Guidelines and Advocating for Clients. Archives of Physical Medicine and Rehabilitation, 88 (6). 807 - 816. ISSN 0003-9993

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Dicianno BE, Tovey E. Power mobility device provision: understanding Medicare guidelines and advocating for clients. The Centers for Medicare and Medicaid (CMS) issued a new national coverage determination (NCD) for mobility assistive equipment (MAE) including wheelchairs in May 2005. CMS then issued a Final Rule in April 2006 that outlined significant changes required for documentation for prescribing MAE. Other insurance providers have since adopted and sometimes modified the NCD criteria and have begun to apply these criteria according to their own interpretations because some of the criteria are vague. In this report, we introduce a case example to show the components of the CMS NCD criteria, what was intended but poorly described in the language, how insurance providers may misinterpret or alter the criteria, and how clinicians can act as advocates. © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Dicianno, BEdicianno@pitt.eduDICIANNO0000-0003-0738-0192
Tovey, E
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 June 2007
Date Type: Publication
Journal or Publication Title: Archives of Physical Medicine and Rehabilitation
Volume: 88
Number: 6
Page Range: 807 - 816
DOI or Unique Handle: 10.1016/j.apmr.2007.03.024
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0003-9993
MeSH Headings: Centers for Medicare and Medicaid Services (U.S.); Cerebral Palsy--complications; Cerebral Palsy--rehabilitation; Consumer Advocacy; Humans; Insurance Coverage--legislation & jurisprudence; Insurance Coverage--standards; Male; Medicare--standards; Orthopedic Equipment; Quadriplegia--complications; Quadriplegia--rehabilitation; United States; Wheelchairs
PubMed ID: 17532908
Date Deposited: 12 Oct 2012 18:30
Last Modified: 05 Feb 2019 00:55


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