CurrentMassachusetts Executive Office of Health and Human ServicesPolicy N/A

Guidelines for Medical Necessity Determination: Standers and Power-Assisted (Dynamic) Standing Components for Wheelchairs

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These Guidelines describe the clinical information MassHealth requires to determine medical necessity for static standers, tilt tables, and power-assisted dynamic standing components for wheelchairs. They apply to MassHealth DME providers requesting prior authorization and address clinical criteria, noncoverage circumstances, and supporting documentation.

Policy Summary

PayerMassachusetts Executive Office of Health and Human Services

PolicyStanders and Power-Assisted (Dynamic) Standing Components for Wheelchairs

Policy CodePolicy N/A

Change TypeNo material change

Effective DateDec 6, 2019

Next Review DateN/A

Key ActionSubmit the prior authorization request no later than 90 calendar days from the prescription date.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

30 minutesMinimum therapeutic standing duration at one time

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