Medicare Criteria

Medicare Billing for Wheelchairs & More 

Chi-Chester's Homecare and Medicare

Thanks for shopping at Chi-Chester's Homecare., a full service medical equipment supplier. Chi-Chester's Homecare is an authorized Medicare provider, and we are happy to assist you in obtaining reimbursement from Medicare for any eligible item(s).

Medicare normally pays 80% of an allowable amount, which varies by state and product category. Generally, Chi-Chester's Homecare prices are well below the allowables for most eligible products, meaning that you would likely be reimbursed at 80% of the price. Therefore, our discounted prices can save you significantly on your 20% co-pay. Please call us at (478) 743-4557 or (866) 515-4557 to determine the allowable amounts for the any of the item(s) you are purchasing.

Medicare courtesy billing for Scooters, Lift Chairs, Walkers & Cushions:

For most items, including most scooters, cushions, lift chairs, and walkers we provide what is known as "courtesy billing", also called "non-assigned" billing. Courtesy billing means you purchase the equipment from us and we handle all of the paperwork to submit a claim to Medicare on your behalf. This includes any paperwork needed from your physician. If Medicare approves your claim, Medicare will reimburse you directly.

Lift Chairs

For lift chairs, Medicare will only cover the seat lift mechanism, but not the actual chair itself. The reimbursement amount is roughly $300 depending on the state in which the patient is located. A lift chair would be considered medically necessary if all of the following coverage criteria are met:

  • The patient must have severe arthritis of the hip or knee, or have a severe neuromuscular disease.
  • The seat lift mechanism must be a part of the physician's course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the patient's condition.
  • The patient must be completely incapable of standing up from a regular armchair or any chair in their home.
  • Once standing, the patient must have the ability to walk.
  • By Medicare standards, the fact that a patient has difficulty or is even incapable of getting up from a chair, particularly a low chair, is not sufficient justification for a seat lift mechanism. Almost all patients who are capable of ambulating can get out of an ordinary chair, if the seat height is appropriate and the chair has arms. Medicare requires that the physician ordering the seat lift mechanism must be the attending physician or a consulting physician for the disease or condition resulting in the need for a seat lift.

Wheelchair Cushions

For wheelchair cushions, Medicare requires that we submit the manufacturer, the model, and the date of purchase of the wheelchair. Please send in this information along with the prescription.