Physician's Resources
Interactive Algorithm
Cornerstone Of Medicare's Policy
Medicare has issued a 9 step algorithmic process to provide clinical guidance in determining what type of Mobility Assistive Equipment (MAE) is reasonable and necessary for beneficiaries who have a mobility related deficit. This algorithm covers all MAE from canes and walkers to power mobility such as scooters and power wheelchairs. When prescribing MAE, you should sequentially consider the specific questions in the algorithm that provide clinical guidance for the coverage of equipment to restore the beneficiary’s ability to participate in Mobility Related Activities to Daily Living (MRADL’s) in customary locations in the home.
This interactive guide sequentially steps through this algorithm to help you determine what MAE Medicare considers appropriate. It also helps you determine what type of documentation is necessary to support and justify the patient's need. Simply answer each question and the guide will lead you through the algorithm.
Question 1
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Does the patient have a mobility limitation that significantly impairs his/her ability to participate in one or more MRADLs in the home?
A mobility limitation is one that:
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Prevents the beneficiary from accomplishing the MRADLs entirely; or
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Places the beneficiary at reasonably determined heightened risk of morbidity or mortality secondary to the attempts to participate in MRADLs; or
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Prevents the beneficiary from completing the MRADLs within a reasonable time frame.
NOTE: Medicare will only cover MAE for in home use. MAE that is needed for use outside the home is not considered reasonable and necessary.