Mobility Scooters

Pride & Dalton Distribution

HCPCS: K0800

Medicare Coverage for Mobility Scooters

Vital Doctors Medical Equipment is an Authorized Pride Mobility® Distributor, a major distributor of Dalton Medical mobility products, and a Medicare-enrolled DME provider. We offer quality mobility solutions from Pride Mobility and Dalton Medical to help patients maintain safe and independent mobility.

The mobility scooters listed below may be eligible for Medicare coverage when prescribed for a qualifying medical need and when all applicable Medicare coverage, documentation, and medical-necessity requirements are met.

Pride Mobility Scooters for Medicare Consideration

• Go Go Elite Traveller Gen 3 — SC443E – 12AH
• Go Go Ultra X Gen 3 — SC493
• Go Go Endurance Li — S54LXLIT – 8AH
• Go Go Elite Traveller 2 4-Wheel — SC442E – 12AH
• Go Go Ultra X 3-Wheel — S39
• Victory 10.2 3-Wheel — S6102
• Victory 10 3-Wheel — SC610 – U1
• Victory 10 4-Wheel — SC710 – U1
• Victory 9 3-Wheel — SC609
• Maxima 3-Wheel — SC901
• Maxima 4-Wheel — SC941
• Go Go Sport 3-Wheel — S73
• Go Go Sport 4-Wheel — S74
• Go Go Elite Traveller 3-Wheel — SC40E – 12AH

Dalton Medical Mobility Scooters for Medicare Consideration

• Dalton Medical SC-42E — 4-Wheel Mobility Scooter — Battery Powered — Headlight — Front Bumper — 265-lb. Weight Capacity

Medicare Requirements

Medicare coverage is determined by the patient’s individual medical condition, mobility limitations, and medical necessity. A prescription or qualifying diagnosis alone does not guarantee Medicare coverage.

Medicare generally requires:

• A face-to-face evaluation with the treating practitioner to evaluate the patient’s mobility limitations and need for a power mobility device.

• A Standard Written Order (prescription) from the treating practitioner.

• Medical records supporting the patient’s diagnosis, functional limitations, and medical need for the prescribed mobility device.

• Documentation demonstrating that the patient’s mobility limitation significantly affects the ability to perform one or more mobility-related activities of daily living (MRADLs) within the home, such as toileting, bathing, dressing, grooming, or eating.

• Documentation showing that a cane or walker does not adequately and safely resolve the patient’s mobility limitation.

• For a mobility scooter, documentation that the patient can safely transfer to and from the scooter, operate the tiller steering system, and maintain sufficient postural stability while operating the device.

• A determination that the prescribed mobility device can be safely used within the patient’s home.

• Completion of any additional Medicare documentation, coverage, or authorization requirements applicable to the prescribed equipment.

Medicare Coverage Is Based on Medical Need Within the Home

Please note: Medicare’s power mobility benefit is based on medical necessity within the patient’s home. Your treating practitioner must document why the mobility scooter is medically necessary to assist you with mobility-related activities of daily living in your home.

A mobility scooter needed solely for shopping, travel, outdoor activities, recreational use, or general community mobility does not by itself satisfy Medicare’s coverage requirements.

Information for Patients & Healthcare Providers

Need assistance with Medicare documentation?

Visit our Patients & Healthcare Resources page for Medicare documentation requirements, patient information, healthcare provider resources, and forms that can assist with the DME qualification and documentation process.

Our team at Vital Doctors Medical Equipment can work with patients and their healthcare providers to help identify the required documentation and determine which Pride Mobility or Dalton Medical mobility product may appropriately meet the patient’s prescribed mobility needs.

Medicare coverage is subject to beneficiary eligibility, medical necessity, applicable Medicare coverage criteria, required documentation, and claim approval. Coverage is not guaranteed.