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HumanaMedicare Advantage · Coverage · Medicare Advantage · PM&R (Physical Medicine & Rehab), Neurology, Occupational Therapy +1 moreMedium impact

Power Wheelchair Accessories - Medicare Advantage (New)

Effective date
May 1, 2026
Identified
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.

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What to do

Action · 4 steps
01Before May 1, 2026: Billing team must update prior authorization processes to include specific medical necessity documentation for power wheelchair accessories per new criteria.
02Providers must document patient's functional limitations and inability to use standard controls when ordering specialized drive control systems.
03Stop billing for tongue drive systems as they are now excluded from coverage.
04Claims without proper medical necessity documentation will be denied.

Codes mentioned

E2312E2313E2321E2322E2324E2325E2326E2327E2328E2329E2330E2373E2374E2375E2376E2377

Original notice

Power Wheelchair Accessories - Medicare Advantage (New)
mcp.humana.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Humana policiesPM&R (Physical Medicine & Rehab)NeurologyOccupational TherapyPhysical TherapyCode E2312Code E2313Code E2321Code E2322Code E2324Code E2325Code E2326Code E2327Code E2328Code E2329Code E2330Code E2373Code E2374Code E2375Code E2376Code E2377

Summaries are AI-assisted. Always confirm against the original payer notice.

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