Power Mobility Devices, Power Operated Vehicle, power wheelchair billing in DME

Power Mobility Devices (PMD)

Prescribing physician/practitioners may bill an additional fee using HCPCS code G0372 on the claim for the office visit (CPT 99211) during which the Medicare required face-to-face examination/evaluation was completed.

Power Operated Vehicle (POV), Basic Equipment Package

Upon initial issue, a POV must include all items below; separate billing/payment is not acceptable.
• Battery or batteries required for operation
• Battery charger, single mode
• Weight appropriate upholstery and seating system
• Tiller steering
• Non-expandable controller with proportional response to input
• Complete set of tires
• All accessories needed for safe operation

Power Mobility Devices (PMD)

Prescribing physician/practitioners may bill an additional fee using HCPCS code G0372 on
the claim for the office visit (CPT 99211) during which the Medicare required face-to-face
examination/evaluation was completed.

Power Operated Vehicle (POV),Basic Equipment Package

Upon initial issue, a POV must include all
items below; separate billing/payment is not
acceptable.
• Battery or batteries required for operation
• Battery charger, single mode
• Weight appropriate upholstery and seating
system
• Tiller steering
• Non-expandable controller with
proportional response to input
• Complete set of tires
• All accessories needed for safe operation

Power Wheelchair, Basic Equipment Package

Upon initial issue, a power wheelchair must include all items below unless otherwise noted;
separate billing/payment is not acceptable.

Inclusion of a code below does not indicate coverage. See the DMEPOS Fee Schedule for
coverage and limitations.

• Lap belt or safety belt (E0978)

• Battery charger, single mode (E2366)
• Complete set of tires and casters any type
(K0090, K0091, K0092, K0093, K0094,
K0095, K0096, K0097, K0099)
• Legrests. Separate billing is not allowed
when swingaway, detachable, nonelevating
legrests with/without calf pad
(K0051, K0052, E0995) are provided.
Elevating leg rests may be billed
separately.

• Fixed/swing-away detachable footrests
with/without angle adjustment
footplate/platform (K0037, K0040,
K0041, K0042, K0043, K0044, K0045,
K0052)
• Armrests. Separate billing is not allowed
when fixed/swingaway, detachable, nonadjustable
armrests with arm pad (K0015,
K0019, K0020) are provided. Adjustable
height armrests may be billed separately.
• Upholstery for seat and back of proper
strength and type for recipient weight
capacity of the power wheelchair (E0981,
E0982)

• Weight specific components per recipient
weight capacity

• Controller and Input Device. Separate
billing is not allowed when a nonexpandable
controller and proportional
input device (integrated or remote) is
provided. If a code specifies an
expandable controller as an option (but not
a requirement) at the time of initial issue,
it may be billed separately.