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Member meets the criteria for and has a medically necessary manual tilt-in-space, manual semi or fully reclining back on a manual wheelchair, manual fully reclining back on a power wheelchair, or power tilt and/or recline seating system.

Mechanical or power shear reduction features A shear reduction feature consists of 2 separate back panels.

The following wheelchair options and accessories may be considered medically necessary when the member meets the medical necessity criteria for a wheelchair. The following table lists some wheelchair options and accessories considered medically necessary (unless otherwise specified) when the member meets the medical necessity criteria for a wheelchair and the options or accessories are necessary for the member to function in the home and perform the activities of daily living and the following medical necessity criteria are met: A sealed battery is separately payable from a power wheelchair base.

Up to 2 batteries at one time are considered medically necessary if required for the power wheelchair.

If the PWC base is considered not medically necessary, then related accessories are considered not medically necessary.

A POV or power wheelchair with Captain's Chair is considered not medically necessary for a member who needs a separate wheelchair seat and/or back cushion.

For a mechanical shear reduction feature, as the posterior back panel reclines or raises there is a mechanical linkage between the 2 panels which allows the user's back to stay in contact with the anterior panel without sliding along that panel.

For members who do not have special skin protection or positioning needs, a power wheelchair with Captain’s Chair provides appropriate support.The wheels must be large enough and positioned such that the wheelchair could be propelled by the user.A standard wheelchair is one with An electric or power wheelchair is a motorized wheelchair.Center for Medicare and Medicaid Services states that the criteria for a power operated vehicle are slightly different than a power wheelchair.A POV is considered medically necessary if all of the basic coverage criteria (A-C) have been met and criteria D-I are also met.




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