A physician must prescribe a power chair or scooter in order for Medicare to pay for it. The Center for Medicare and Medicaid Services (CMS) has established an add-on code billing, G0372, to the face-to-face mobility evaluation that allows you to be paid for compiling and submitting the required documentation.

A power chair or scooter can enable your patients to regain their independence in their home because it lets them do the everyday activities that they once did before.  

Medicare guidelines require a face-to-face mobility evaluation prior to writing a prescription for a power chair or scooter. You must document in the chart notes that the mobility evaluation is the main purpose of the office visit.

During the face-to-face mobility evaluation, the following seven questions are used to determine if the patient qualifies:

• Does the beneficiary have a mobility limitation that impairs his/her ability to participate in one or more MRADLs (Mobility-Related Activities of Daily Living) in the home?
• Does the beneficiary or caregiver demonstrate the capability and the willingness to consistently operate the equipment safely?
• Can the functional mobility deficit be safely and effectively resolved by the use of a cane or walker?
• Does the beneficiary have any limitations that might make it difficult to regularly self-propel a manual wheelchair in the home to participate in MRDALs during a typical day?
  
  

PLEASE NOTE: Once you have completed the face-to-face mobility evaluation and determined that your patient would benefit from power mobility equipment, you will need to provide the following documentation in a timely manner:

• Prescription for an electric wheelchair (u-Scoot will provide the form)
• Chart notes that detail the patient's mobility need as determined during the face-to-face mobility evaluation (see above)
• Chart notes from the 4 visits prior to the face-to-face mobility evaluation

Once u-Scoot has determined the specific power chair or scooter that is appropriate for the patient based on your notes, we must prepare a written document that lists the specific base (HCPCS code and either a narrative description of the item or the manufacturer name/model). The physician must sign and date this form.

The chart notes of the face-to-face examination shall provide information relating to the following questions:

The report shall provide pertinant information about the following elements, but may include other details. Each element would not have to be addressed in every evaluation.

• Symptoms
• Related diagnoses
• History
• How long the condition has been present
• Clinical progression
• Interventions (including medications) that have been tried and the results
• Past use of walker, manual wheelchair, scooter, power chair and the results
• Physical exam
• Weight
• Impairment of strength, range of motion, sensation, or coordination of arms and legs
• Presence of abnormal tone or deformity of arms, legs, or trunk
• Neck, trunk, and pelvic posture and flexibility
• Sitting and standing balance

The elements that are addressed will depend on the diagnoses that are responsible for the mobility deficit.

PLEASE NOTE: Medicare's coverage of a power chair is determined solely by the patient's mobility needs within the home.