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MedicaidCoverageMedium impact

Mobility Assistive Devices (Wheelchairs) - MEDICAID - KENTUCKY (New)

Humana·KY · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy +2 more·Medicaid
Effective date
Mar 26, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

New Humana Kentucky Medicaid policy establishes comprehensive coverage criteria for mobility assistive devices including manual wheelchairs, power wheelchairs, and scooters. The policy requires specific medical documentation, specialty evaluations for advanced devices, and home assessments for power wheelchairs.

Action Required

Action needed
Before March 26, 2025: Billing team must update Kentucky Medicaid wheelchair authorization processes to require licensed healthcare provider orders with specific device documentation, specialty evaluations by licensed PT/OT for ultra-lightweight and power wheelchairs with special features, and home assessments for all power wheelchair requests. Update encounter forms and EMR templates to ensure documentation of ADL limitations and medical necessity criteria. Claims without proper documentation will be denied.

Affected Billing Codes

E1130
E1140
E1221
K0001
E1085
K0002
E1260
K0003
K0005
E1090
K0004
E1093
E1290
K0006
K0007
E1229
E1231
E1232
E1233
E1234
E1235
E1236
E1237
E1238
E0986
E1239
K0010
K0011
K0012
K0813
K0814
K0815
K0816
K0820
K0821
K0822
K0823
K0824
K0825
K0826
K0827
K0828
K0829
K0835
K0836
K0837
K0838
K0839
K0840
K0841
K0842
K0843