MedicaidPrior AuthHigh impact
Prior Approval Required for All Wheelchair and Power-Operated Vehicle (POV) Repairs Effective June 1, 2013
Illinois Medicaid - HFS·IL · PM&R (Physical Medicine & Rehab), Occupational Therapy, Physical Therapy·Provider Notice
Effective date
Jun 1, 2013
We identified it
Jun 20, 2026
Summary
Starting June 1, 2013, all wheelchair and power-operated vehicle repairs require prior approval using HFS 1409 form before billing. Repairs exceeding 75% of the department's purchase price will not be covered.
Action Required
By June 1, 2013: DME providers must submit HFS 1409 Prior Approval Request form for all manual/power wheelchair and POV repairs before providing services. Include brand name, model, serial number, purchase date, itemized repair breakdown, and warranty information. Use code K0108 for uncoded items. For paper claims (HFS 2210), enter last 8 digits of prior approval number and use 'Purch/Rent' code '1'. For electronic claims (837P), enter all 10 digits of prior approval number in Loop 2300 REF02 and use modifier 'NU'. Claims without prior approval will be denied.