Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-543 - Medical equipment, supplies, and appliances
Section 182-543-4000 - Covered - Wheelchairs - General

Universal Citation: WA Admin Code 182-543-4000

Current through Register Vol. 24-18, September 15, 2024

(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.

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. 11-14-052, § 388-543-4000, filed 6/29/11, effective 8/1/11.

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