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24.5.26.9 Scooters
A scooter is a professionally manufactured, three or four-wheeled motorized base with a professionally manufactured basic seating system for clients who have little or no positioning needs.
Scooters may be approved for a short term rental or initial three-month trial period based on documentation supporting the medical necessity and appropriateness of the device.
Scooters may be considered for reimbursement for ambulatory impaired clients with good head, trunk and arm/hand control, without a diagnosis of progressive illness such as progressive neuromuscular diseases such as amyotrophic lateral sclerosis.
Assessment of the accessibility of the client's residence must be completed and included in the prior authorization documentation to ensure that the scooter is usable in the home such as doors and halls wide enough, no obstructions.
All scooters must have a growth potential, which must accommodate 20 percent of height and weight changes.
To request prior authorization for a scooter the client must not own or be expected to require a power wheelchair within five years of the purchase of a scooter.
All documentation required for a standard power wheelchair must be provided, along with the following documentation:
• The client's physical and cognitive ability to receive and follow instructions related to the responsibilities of using the equipment.
•The ability of the client to physically and cognitively operate the scooter independently.
•The capability of the client to care for the scooter and understand how it operates.
•A completed Wheelchair/Scooter/Stroller Seating Assessment Form with seating measurements that includes documentation supporting medical necessity, except when requesting a standard sling seat/sling back wheelchair.
Custom seating for scooters is not a benefit of Home Health Services.
Repairs to scooters may be considered only for those scooters purchased by the Texas Medicaid Program.
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