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2.5.9.2 Prior Authorization and Documentation Requirements
Prior authorization is required for all mobility aids and related services, except travel safety restraints, for clients with a medical condition requiring them to be transported in either a prone or supine position.
Mobility aid equipment that has been purchased is anticipated to last a minimum of five years and may be considered for replacement with prior authorization when five years have passed or the equipment is no longer repairable. Prior authorization for replacement of mobility aid equipment may also be considered when loss or irreparable damage has occurred. A copy of the police or fire report, when appropriate, and the measures to be taken to prevent recurrence must be submitted.
When prior authorization of a mobility aid replacement is requested before five years have passed, the following information must be submitted with the request:
• A statement from the prescribing physician or licensed OT or PT
•Documentation supporting why the equipment no longer meets the client's needs
HHSC or its designee determines whether the equipment is rented, purchased, repaired, or modified based on the client's needs, duration of use, and age of equipment.
Rental of equipment includes all necessary accessories, supplies, adjustments, repairs, and replacement parts.
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