Medicare Details

Medicare Invoicing for Wheelchairs & More

Certified Medical Systems and Medicare

Thank You for making a purchase with Certified Mobility, an extensive medical equipment provider. Certified Mobility is an approved Medicare source, and we are pleased to lend you a hand in acquiring compensation from Medicare for any qualified purchase(s). Items entitled to Medicare reimbursement are clearly marked on the Certified Mobility website.
Medicare normally pays 80% of an allowable amount, but can vary from state to state. Generally, Certified Mobility prices are comparable to other medical equipment companies and reimbursement is at 80% of the allowed amount on most products. As a result, our discounted prices can save you considerably. Please call Certified Mobility customer service at 1-800-815-1211 to determine the permitted amounts of any product(s) you are obtaining.

Certified Mobility manages claims for patients without HMO Medicare as their primary insurance coverage. An HMO is a secondary insurance group whose services have been enlisted to manage your Medicare coverage and benefits. Certified Mobility will verify your eligibility before processing your order.

Medicare “Non-Assigned” billing for Scooters, Lift Chairs, Walkers and Cushions:

Certified Mobility offers "non-assigned" billing for most of its products, including scooters, cushions, lift chairs, and walkers. Non-assigned billing means you acquire the equipment from Certified Mobility, and Certified Mobility processes all of the paperwork needed to present a claim to Medicare on your behalf. This includes your physician documentation. Once Medicare approves your claim, you will receive your reimbursement directly from Medicare.

Lift Chairs
Because Medicare will only provide funding for the seat lift mechanism, instead of the actual chair itself, the compensation amount is approximately $337.32 depending on the state in which the patient currently resides. The criteria for obtaining a lift chair are as follows:
The patient must have severe arthritis of the hip or knee, or have a severe neuromuscular disease. The patient must be completely incapable of standing up from a regular armchair or any chair in their home. Once standing, the patient must have the ability to ambulate. The patient must have tried all therapeutic modalities to enable them to transfer from a chair to a standing position. Medicare requires that the physician ordering the seat lift mechanism must be the attending physician or a consulting physician for the disease or condition resulting in the need for a seat lift.

Wheelchair Cushions

Medicare requires that Certified Mobility submit the manufacturer, the model, and the date of purchase of the wheelchair cushions to be properly billed. A Certificate of Medical Necessary must be on file.

Medicare billing for Power Chairs and Scooters:

For power chairs and scooters, Certified Mobility offer, "assigned billing". Certified Mobility handles all of the paperwork with your physician, supply the requested equipment and then bill Medicare and a secondary insurance. Medicare will reimburse Certified Mobility directly for the power chair or scooter. Please call our customer service department at 1-800-815-1211 and talk to a Medicare specialist about purchasing a power chair and billing Medicare. Our specialists will determine over the phone if you may be eligible, and can help you to select the power chair or scooter that Medicare will pay for.

What to expect

If you are purchasing a scooter or a power wheelchair you will speak with a Certified Mobility customer service representative regarding your specific circumstances and to gather information regarding eligibility. The process involves these simple steps:

Step 1. Call 1-800-815-1211 and ask to talk to a Certified Mobility Medicare Specialist. Our specialist will ask you a series of questions to help determine if a scooter or power chair will meet your need and if you are eligible for Medicare coverage. We will also ask you some basic questions about your home to determine what time of mobility equipment can be used safely inside the home.

Step 2. The next step is a visit with your physician. Certified Mobility will e-mail, fax or mail you a packet with instructions to take to your physician.

Step 3. Your physician will perform an assessment to determine your power mobility needs, and if appropriate, will write a prescription and make appropriate notes in your chart. If the doctor does not feel comfortable completing the assessment, they may refer you to an occupational or physical therapist. If a therapist completes the evaluation a copy will be provided to your physician to place in your chart.

Step 4. The physician will mail or fax the prescription, along with supporting documentations and chart notes, to Certified Mobility. Certified Mobility MUST receive this information within 45 days of when your prescription and assessment were completed.

Step 5. A Certified Mobility Medicare expert will review the paperwork for accuracy and completeness. Within two-business day of when your paperwork is received, our Medicare specialists will contact you to further discuss your prescription and information. If the information meets Medicare's coverage criteria Certified Mobility will collect the co-pay and deliver your scooter or power chair as soon as possible, usually within 3 business days. A thorough demonstration will also be completed at this time.

Power Chair and Scooter Coverage Criteria

The general criteria for power chairs and scooter qualifications are as follow:

The beneficiary must have a mobility limitation that prevents them from performing one or more mobility related activities of daily living in the home, including daily living activities.

A cane, walker, or manual wheelchair will not provide the necessary functional mobility.
The beneficiary must demonstrate the capability and the willingness to consistently operate the equipment safely.

The beneficiary’s home must allow for the use of a power wheelchair or scooter in all areas where the mobility related activities of daily living are performed.

For a scooter, the beneficiary must have upper body strength and postural stability.

For a power chair, the additional features provided by a power chair must be required by the beneficiary in order to perform one or more mobility-related activities of daily living.