*This is an archive page. The links are no longer being updated.
1993.07.06 :  Final Regulation Regarding Customized Wheelchairs

Contact:  Anne Verano (202) 690-6145
July 6, 1993

     Bruce C. Vladeck, administrator of the Health Care Financing
Administration, has announced a final regulation that defines
customized wheelchairs for purposes of payment under the Medicare
program.
     Under the proposal, Medicare will pay for customized
wheelchairs when medical necessity dictates the need for features
not already available in the market place and when they are
prescribed by a physician.  The regulation provides the criteria
a wheelchair must meet to be classified as customized.
     To be considered customized, a wheelchair must be uniquely
constructed or substantially modified to meet the specific needs
of an individual patient.  Because a customized wheelchair is so
different from any other available, it must be handled
individually for payment purposes.
     The regulation allows payment for the purchase of customized
items, based on the Medicare carrier's case-by-case determination
of a reasonable payment amount for each customized item.  The
cost of labor, support services and materials are also included
within payment rates for customized items.
     Medicare carriers, private insurance organizations that
contract with the federal government to handle claims and make
Medicare payments, must individually accept and process these
items based on their judgment.  The rule does allow for a lump
sum payment for the purchase of customized equipment based on the
carrier's decision of reasonable payment.
     This final rule was published in the Federal Register on
June 30, *This is an archive page. The links are no longer being updated.
1993.  It replaces the interim rule published in the
Federal Register Dec. 20, 1991, and includes consideration of the
public comments on the interim rule.

Editor's Note: HCFA, an agency of the U.S. Department of Health
and Human services, directs the Medicare and Medicaid programs,
which help pay the medical bills of more than 67 million
Americans.  HCFA's estimated fiscal year 1993 expenditures are
almost $230 billion.