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Physician's Resources

Canes and Walkers

Coverage Criteria

A standard cane or walker and related accessories are covered if all of the following criteria (1-3) are met: 

1) The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home.

A mobility limitation is one that:

a) Prevents the patient from accomplishing the MRADL entirely, or

b) Places the patient at reasonably determined heightened risk of morbidity or mortality secondary to the attempts to perform the MRADL, or

c) Prevents the patient from completing the MRADL within a reasonable time frame;

and 

2) The patient is able to safely use the walker; and 

3) The functional mobility deficit can be sufficiently resolved with use of a cane or walker.  

 If all of the criteria are not met, the cane or walker will be denied as not medically necessary.


Written Order Requirements

  1. When prescribing a walker the written prescription must contain the following:

  2. Beneficiary’s name

  3. Description of item that is ordered. This may be general – e.g. “front wheeled walker”- or may be more detailed.

  4. Pertinent diagnosis/conditions that relate to the need for the MAE

  5. Length of need

  6. Physician’s signature

  7. Date of physician’s signature


Documentation Requirements

Medicare expects that the patient’s clinical record will document and justify the need for the prescribed MAE using the algorithmic approach.  This documentation does not need to be sent to the supplier when prescribing a cane or walker but does need to be available upon request by Medicare.

 

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