Walkers

 
Note:  The following coverage criteria is for Medicare, other insurances may have different criteria and may be less stringent.  In most cases, meeting Medicare criteria will meet all other criteria’s.

• A written signed and dated prescription prior to dispensing is required before a walker is covered by Medicare.
• The face to face notes must include the conditions for coverage  as described below (these must be completed and signed prior to dispensing the item):

CRITERIA FOR A WALKER
 
A standard walker and related accessories are covered if all the following Criteria 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.
2. All less costly alternative have been tried or ruled out such as a cane or quad cane.
3. A mobility limitation is one that:
   • Prevents the patient from accomplishing the MRADL entirely, or
   • Places the patient at reasonably determined heightened risk of morbidity or mortality secondary to the attempts to perform the MRADL, or
   • Prevents the patient from completing the MRADL within a reasonable time frame; and
   • The patient is able to safely use the walker; and
   • The functional mobility deficit can be sufficiently resolved with the use of a walker

If all of the Criteria are not met, the walker will be denied as not medically necessary.
A heavy duty walker is covered for patients who meet coverage Criteria for a standard walker and who weigh more than 300 pounds. If a walker is provided and the patient does not weigh more than 300 pounds but does meet coverage Criteria for a standard walker, payment will be based on the allowance for the least costly medically appropriate alternative, respectively.
The medical necessity for a walker with an enclosed frame compared to a standard folding wheeled walker has not been established.