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Wheelchairs and Power Operated Vehicles (Scooters) (CPB 0271, reviewed 2026-08-21)
Effective date
Not stated in the notice
Identified
Oct 6, 2026
Summary
Power mobility devices, including power operated vehicles (scooters), power wheelchairs and push-rim activated power assist devices, are considered medically necessary only when the member has a mobility limitation that significantly impairs mobility-related activities of daily living in the home and that limitation cannot be sufficiently and safely resolved with an appropriately fitted cane or walker. Power operated vehicles and power wheelchairs are considered not medically necessary when they are needed only for use outside the home, and Group 2 power operated vehicles (K0806 to K0808) are considered not medically necessary because they have added capabilities that are not needed for use in the home. Cup holders, dynamic seating, lighting systems and snow tires are listed as not covered.
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What to do
Action · 9 steps
01Before billing these services, confirm the Standard Written Order was communicated to the supplier, because claims without a completed SWO will be denied as not medically necessary.
02Keep proof of delivery on file for every service, since services without appropriate proof of delivery will be denied as not medically necessary.
03Obtain a new prescription from the treating practitioner each time a new device or repair is requested.
04For a power wheelchair, the face-to-face or telehealth encounter must occur within 6 months before the written order, must be documented in the medical record, and the written order must reference the conditions documented in that encounter.
05For ultralightweight manual wheelchairs, tilt-in-space manual wheelchairs, Group 2 single or multiple power option power wheelchairs, any Group 3 power wheelchair and power add-on devices, obtain a specialty evaluation by a licensed or certified medical professional, and confirm the supplier employs a RESNA-certified Assistive Technology Professional who performs a home assessment and documents that the home is accessible for the wheelchair.
06Confirm the device is provided within 6 months of the date of prescription.
07Stop billing rental items or ongoing supplies once the member no longer uses them.
08Claims that do not meet coding guidelines will be denied as not medically necessary or incorrectly coded.
09Check current applicability of this policy before applying it, since the source lists its next review as 03/11/2027.
Codes mentioned
E0150E0953E0955E0956E0957E0960E0973E0983E0986E0990E0995E1002E1003E1004E1005E1006E1007E1008E1009E1010E1012E1028E1034E1037E1038E1039E1161E1229E1231E1232E1233E1234E1235E1236E1238E2213E2298E2341E2342E2343E2609E2617K0002K0003K0004K0005K0006K0007K0008K0013K0042K0043K0044K0045K0046K0047K0052K0053K0195K0806K0808K0813K0814K0815K0816K0820K0822K0823K0824K0825K0826K0827K0828K0829K0830K0831K0835K0836K0837K0838K0839K0840K0841K0842K0843K0848K0849K0850K0851K0852K0853K0854K0855K0856K0857K0858K0859K0860K0861K0862K0863K0864K0868K0869K0870K0871K0877K0878K0879K0880K0884K0885K0886K0890K0891
Original notice
Wheelchairs and Power Operated Vehicles (Scooters) (CPB 0271, reviewed 2026-08-21)
aetna.com · Always check the source before changing claims.
Related changes
See all Aetna changes →Wheelchairs and Power Operated Vehicles (Scooters) (CPB 0271, reviewed 2025-12-18)MediumNo effective date · DMETherapeutic Chairs (CPB 0434, reviewed 2026-08-03)MediumNo effective date · Medical PolicyAmbulatory Assist Devices: Canes, Crutches, and Walkers (CPB 0505, reviewed 2026-08-03)MediumNo effective date · Medical PolicyBrowse every Aetna change in the policy list
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