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AetnaAll Plans · Coverage · Medical Policy · PM&R (Physical Medicine & Rehab), Physical Therapy, PediatricsMedium impact

Ambulatory Assist Devices: Canes, Crutches, and Walkers (CPB 0505, reviewed 2026-08-03)

Effective date
Not stated in the notice
Identified
Aug 17, 2026

Summary

Aetna considers canes, crutches, and walkers medically necessary durable medical equipment when the member has a mobility limitation that significantly impairs participation in one or more mobility-related activities of daily living (MRADL) in the home, the member can safely use the device, and the functional deficit can be sufficiently resolved by the device. Axillary, articulated, spring-assisted crutches, sit-and-stand walking assistant crutches, walkers with enclosed frames, walking belts, and standard strollers are not considered medically necessary, and enhancement accessories such as style, color, seat attachments, tray attachments, baskets, or cup holders are not covered. The AutoAmbulator, battery or electronic powered walkers such as the Sully Walker, the Upsee mobility device, and the wearable freezing of gait detection system are considered experimental, investigational, or unproven.

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What to do

Action · 6 steps
01Billing team: Bill only the HCPCS codes listed as covered when criteria are met, and do not bill the enhancement accessories the policy lists as not covered.
02Bill the walker accessories listed in the policy's Appendix (for example, replacement handgrips, replacement tips, wheel attachments and brake attachments) without a separate charge when they are provided at the same time as the item they accompany, since the policy states they must not be billed separately.
03Obtain a new prescription from the treating practitioner (physician MD or DO, physician assistant, nurse practitioner, or clinical nurse specialist) each time a new device or repair is requisitioned; prosthetists, orthotists, physical therapists and occupational therapists are not treating practitioners under this policy.
04Keep medical record documentation that supports medical necessity and substantiates any supplier-prepared statement or practitioner attestation, because a supplier statement or physician attestation alone is not sufficient.
05Communicate a Standard Written Order to the supplier before the claim is submitted, and include the member's name or identification number, the order date, a general description of the item (HCPCS code, HCPCS narrative, or brand name and model), each concurrently ordered option or accessory listed separately, the HCPCS code and quantity for each item, the treating practitioner's name and national provider identifier, and the treating practitioner's signature.
06The policy states that a claim billed without a completed Standard Written Order will be denied as not medically necessary.

Codes mentioned

A4635A4636A4637E0100E0105E0110E0111E0112E0113E0114E0116E0118E0130E0135E0140E0141E0143E0147E0148E0149E0150E0153E0154E0155E0157E0158E0159E0638E0641E0642E1031E8000E8001E8002E0117E0144E0152E0156G11.0G11.9G12.0G12.9G13.0G13.8G14G24.1G31.9G71.00G71.09G80.0G80.9G81.00G82.54Q05.0Q05.9Q06.9Q68.8Q74.3Q76.411Q76.49Q93.4Q99.811Q99.89

Original notice

Ambulatory Assist Devices: Canes, Crutches, and Walkers (CPB 0505, reviewed 2026-08-03)
aetna.com · Always check the source before changing claims.
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Related policy hubs

Aetna policiesPM&R (Physical Medicine & Rehab)Physical TherapyPediatricsCode A4635Code A4636Code A4637Code E0100Code E0105Code E0110Code E0111Code E0112Code E0113Code E0114Code E0116Code E0118Code E0130Code E0135Code E0140Code E0141Code E0143Code E0147Code E0148Code E0149Code E0150Code E0153Code E0154Code E0155Code E0157Code E0158Code E0159Code E0638Code E0641Code E0642Code E1031Code E8000Code E8001Code E8002Code E0117Code E0144Code E0152Code E0156Code G11.0Code G11.9Code G12.0Code G12.9Code G13.0Code G13.8Code G14Code G24.1Code G31.9Code G71.00Code G71.09Code G80.0Code G80.9Code G81.00Code G82.54Code Q05.0Code Q05.9Code Q06.9Code Q68.8Code Q74.3Code Q76.411Code Q76.49Code Q93.4Code Q99.811Code Q99.89

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