Medicare AdvantageCoverageMedium impact
Power Wheelchair Accessories - Medicare Advantage (New)
Humana·PM&R (Physical Medicine & Rehab), Neurology, Occupational Therapy +1 more·Medicare Advantage
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
New Humana Medicare Advantage policy establishes medical necessity criteria for power wheelchair drive control systems and accessories. The policy specifies coverage requirements for various control types including joystick, sip-and-puff, chin control, and expandable controllers, while excluding tongue drive systems from coverage.
Action Required
Before May 1, 2026: Billing team must update prior authorization processes to include specific medical necessity documentation for power wheelchair accessories per new criteria. Providers must document patient's functional limitations and inability to use standard controls when ordering specialized drive control systems. Stop billing for tongue drive systems as they are now excluded from coverage. Claims without proper medical necessity documentation will be denied.