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Medicare considers wheelchairs as a "capped rental" item. This means that Medicare will rent the wheelchair for 13 monthly payments after which it will "cap out" and the beneficiary will own the wheelchair. Medicare does not consider a lightweight, ultra-lightweight, heavy duty, or modified chair medically necessary without doctors notes that support the medical need for such add-ons. If your physician feels a wheelchair is medically necessary, they must chart in the patient notes that they feel it is necessary and the reason why it is necessary verses a cane, walker or crutch.
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A In almost all cases, manual wheelchairs are covered by Medicare as a "Capped Rental." This means that Medicare pays approx. 80% of the monthly rental and you are responsible for the remaining 20% or this may be covered by secondary insurance. You must use a local dealer that rents chairs and bills Medicare for the monthly rental fees. Some Ultra-lightweight wheelchairs have a K0005 Billing code and can be billed as a purchase. All manual wheelchairs on our website are for purchase only. Medicare does not reimburse for the purchase of a wheelchair.
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Are manual wheelchairs covered by Medicare?
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