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Power Mobility Device (PMD) FaceToFace Evaluation Patient: SS#: Insurance: Referring Doctor: Date of Birth: MR#: Policy #: Date of Examination: FACETOFACE EVALUATION FOLLOWUP POST SPECIALTY EVALUATION.

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A face-to-face mobility examination, sometimes referred to as an in-office mobility evaluation, is a required doctor's office visit. It is mandated by Medicare and must occur prior to receiving a power wheelchair prescription. Patient mobility must be the primary focus of the examination.

If you think you need a power wheelchair or scooter, first speak to your doctor or primary care provider (PCP). If your PCP determines that it is medically necessary that you use a power wheelchair or scooter, they should sign an order, prescription, or certificate after a face-to-face office visit.

The mobility assessment is a holistic assessment conducted by an Occupational Therapist.

In most cases the physical assessment will also include a full musculoskeletal examination of the users range of motion, joint flexibility, muscle length, and skeletal alignment, with neurological issues such as tone and spasm pattern also noted as they affect posture and muscle length.

Power wheelchairs and power operated vehicles (also known POVs or scooters) are collectively ified as Power Mobility Devices (PMDs) and are covered under the Medicare Part B benefit. CMS defines a PMD as a covered item of DME that includes a power wheelchair or a POV that a beneficiary uses in the home.

A physician may only write a prescription must contain the following seven elements: 1-Beneficiary's name. 2-Description of the item that is to be ordered. This may be general e.g, "power operated vehicle(POV)," "power wheelchair," or "power mobility device" - or may be more specific.

APATIENT MOBILITY assessment is a. process for determining how much a patient can move, what equipment or aides will be necessary for them to complete a daily task, such as walking or toileting and how much support their caregiver must provide if the patient has limitations.

Qualifying Diagnoses for Wheelchairs Multiple Sclerosis (MS) ALS (AKA Lou Gehrig's Disease) Parkinson's Disease. Spinal Cord Injuries. Cerebral Palsy. Muscular Dystrophy. CVA (AKA stroke-related paralysis) Post-Polio Syndrome.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232