PDFWAC 182-543-4000
Covered—Wheelchairs—General.
(1) The medicaid agency covers, with prior authorization, manual and power-drive wheelchairs for clients who reside at home. For clients who reside in a skilled nursing facility, see WAC 182-543-5700.
(2) For manual or power-drive wheelchairs for clients who reside at home, requests for prior authorization must include all of the following completed forms:
(a) General Information for Authorization form (HCA 13-835). The agency's electronic forms are available online (see WAC 182-543-7000, Authorization);
(b) A Prescription Form (HCA 13-794); and
(c) Medical Necessity for Wheelchair Purchase (for home clients only) form (HCA 13-727) from the client's physician or therapist. The date on this form (HCA 13-727) must not be prior to the date on the Prescription Form (HCA 13-794).
(3) The agency does not pay for manual or power-drive wheelchairs that have been delivered to a client without prior authorization from the agency.
(4) When the agency determines that a wheelchair is medically necessary, according to the process found in WAC 182-501-0165, the agency rents or purchases a wheelchair for clients who live at home. For clients who reside in a skilled nursing facility, see WAC 182-543-5700.
[Statutory Authority: RCW 41.05.021 and 2013 c 178. WSR 14-08-035, § 182-543-4000, filed 3/25/14, effective 4/25/14. WSR 11-14-075, recodified as § 182-543-4000, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.04.050. WSR 11-14-052, § 388-543-4000, filed 6/29/11, effective 8/1/11.]