Medicare wheelchair and power mobility coverage: where PTs and OTs come in
Medicare Part B covers wheelchairs and scooters as durable medical equipment when they are medically necessary. For a power wheelchair or scooter, Medicare requires a face-to-face visit and a written order from the treating practitioner. A local coverage policy for power mobility devices adds a “specialty evaluation” for certain power wheelchairs, done by a licensed or certified medical professional “such as a PT or OT” with no financial tie to the supplier. This page quotes Medicare and CMS and copies no payment amounts.
Quoted from official pages checked November 12, 2026. Confirm current requirements, fees, and dates on those sites. This page is not legal advice and does not guarantee eligibility, certification, or licensure.
Sources read on November 12, 2026: Medicare.gov’s Wheelchairs & scooters page; 42 CFR 410.38 on eCFR (displayed as up to date as of 11/09/2026); CMS’s National Coverage Determination 280.3, Mobility Assistive Equipment (MAE) (effective date of the version shown: 05/05/2005); and Local Coverage Determination L33789, Power Mobility Devices in CMS’s Medicare Coverage Database. The LCD copy read is published by CGS Administrators, LLC, the DME MAC for Jurisdiction B, and is the revision listed as effective “For services performed on or after 12/20/2026”. Check the version that applies to your jurisdiction and date of service.
What Medicare covers
Medicare.gov states that Part B “covers wheelchairs and power-operated vehicles (scooters) if you’re eligible”. It adds: “You must have a face-to-face examination and a written prescription from a treating provider before Medicare covers a power wheelchair or scooter.” And: “Medicare will only pay for DME items if you get them from suppliers who are enrolled in Medicare.”
On prior authorization for certain power wheelchairs, Medicare.gov says: “If your physician prescribes one of these wheelchairs to you, your DME supplier will usually submit a prior authorization request and all documentation to Medicare on your behalf.”
The federal regulation, 42 CFR 410.38, states: “Medicare Part B pays for durable medical equipment, including ventilators, oxygen equipment, hospital beds, and wheelchairs, if the equipment is used in the patient's home or in an institution that is used as a home.” For power mobility devices it requires that “the treating practitioner must document and communicate to the DMEPOS supplier that the treating practitioner has had a face-to-face encounter with the beneficiary within the 6 months preceding the date of the written order/prescription.” Medicare.gov says “face-to-face examination”; the regulation says “face-to-face encounter”. Both are shown here as written.
The national rule: mobility assistive equipment
NCD 280.3 says CMS uses the term “mobility assistive equipment” for a group of items and “includes within that category canes, crutches, walkers, manual wheelchairs, power wheelchairs, and scooters.” It states: “Effective May 5, 2005, CMS finds that the evidence is adequate to determine that MAE is reasonable and necessary for beneficiaries who have a personal mobility deficit sufficient to impair their participation in mobility-related activities of daily living (MRADLs) such as toileting, feeding, dressing, grooming, and bathing in customary locations within the home.”
It adds: “The beneficiary, the beneficiary’s family or other caregiver, or a clinician, will usually initiate the discussion and consideration of MAE use.” The NCD text read does not name physical or occupational therapists.
The power mobility policy (LCD L33789)
The LCD’s general criteria start with this one: “The beneficiary has a mobility limitation that significantly 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.” Another is: “The beneficiary’s mobility limitation cannot be sufficiently and safely resolved by the use of an appropriately fitted cane or walker.”
The specialty evaluation
For several power wheelchair groups, the LCD requires: “The beneficiary has had a specialty evaluation that was performed by an LCMP, such as a PT or OT, or practitioner who has specific training and experience in rehabilitation wheelchair evaluations and that documents the medical necessity for the wheelchair and its special features (refer to the documentation requirements section).” It adds: “The PT, OT, or practitioner may have no financial relationship with the supplier.”
Which devices need it: “The specialty evaluation that is required for beneficiaries who receive non-complex Group 2 seat elevator PWCs, Group 2 Single Power Option or Multiple Power Options PWC, any Group 3 PWC, any Group 5 PWC, or a power assist system is in addition to the requirement for the face-to-face encounter.” The seat elevator wheelchair criteria are listed in the LCD’s revision history as added in the revision effective 12/20/2026.
On LCMP reports and the face-to-face encounter, it states: “If the report of an LCMP examination is to be considered as part of the face-to-face encounter (refer to the LCD-related Policy Article), there must be a signed and dated attestation by the supplier or LCMP that the LCMP has no financial relationship with the supplier.”
The supplier’s ATP and the home assessment
For the same groups, the LCD requires: “The wheelchair is provided by a supplier that employs a RESNA-certified ATP who specializes in wheelchairs and who has direct, in-person involvement in the wheelchair selection for the beneficiary.” That credential is on RESNA’s ATP page; RESNA’s seating credential is on the SMS page.
It also states: “Prior to or at the time of delivery of a POV or PWC, the supplier or practitioner must perform an on-site evaluation of the beneficiary’s home to verify that the beneficiary can adequately maneuver the device that is provided considering physical layout, doorway width, doorway thresholds, and surfaces.”
What this page does not do
It does not copy payment amounts, codes beyond the group names, or the full criteria, and it does not say whether any patient qualifies. It is not legal, medical, billing, or immigration advice. Confirm current rules with the agency or organization that publishes them, your employer, and your state board.