Manual Wheelchair

Click To Print Process Steps

Manual wheelchairs

Request For Manual Wheelchair


Manual Wheelchair Criteria

The primary reason/complaint for the face-to-face doctor visit should be stated as, “Mobility Evaluation”. Qualification for eligibility includes:

  1. Patient cannot walk, even with the support of other mobility equipment (rule out why a cane, crutches or walker is not sufficient).
  2. The patient would spend most of his/her time in bed or in a chair without the use of a wheelchair.
  3. The patient is able to transfer safely in and out of the wheelchair.
  4. The patient is able to sit, ride and safely operate the wheelchair.
  5. The primary reason for needing the wheelchair is to help the patient move about independently, not to prevent an injury from occurring where no injury or illness exists (even though it will help prevent injury as well).
  6. The primary use of the wheelchair will be in the home.


Click to PRINT Codes for Manual Wheelchair