National Coverage Determination (NCD)

Specially Sized Wheelchairs


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Tracking Information

Publication Number
Manual Section Number
Manual Section Title
Specially Sized Wheelchairs
Version Number
Effective Date of this Version
This is a longstanding national coverage determination. The effective date of this version has not been posted.
Ending Effective Date of this Version

Description Information

Benefit Category
Durable Medical Equipment

Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Indications and Limitations of Coverage

Payment may be made for a specially sized wheelchair even though it is more expensive than a standard wheelchair. For example, a narrow wheelchair may be required because of the narrow doorways of a patient's home or because of a patient's slender build. Such difference in the size of the wheelchair from the standard model is not considered a deluxe feature.

A physician's certification or prescription that a special size is needed is not required where you can determine from the information in file or other sources that a specially sized wheelchair (rather than a standard one) is needed to accommodate the wheelchair to the place of use or the physical size of the patient.

To determine the reasonable charge in these cases, use the criteria set out in the Medicare Claims Processing Manual, Chapters 12 and 23, as necessary.

Cross Reference
Also see the Medicare Benefit Policy Manual, Chapter 13 §30.1 and Chapter 15 §110, and the Medicare Claims Processing Manual, Chapter 20 §§20.2 and 30.5.3.

Additional Information

Other Versions
Title Version Effective Between
Mobility Assistive Equipment (MAE) 2 05/05/2005 - N/A View
Specially Sized Wheelchairs 1 01/01/1966 - 05/05/2005 You are here