23 Miss. Code. R. 209-1.25 - Gait Trainer

A. The Division of Medicaid defines a gait trainer as a device similar to a walker and consists of a wide based steel frame with four (4) casters/wheels and may include a seat or support accessories. The user has difficulty with balance and control of the trunk, has an unsteady gait and is uncoordinated in ambulation.

B. The Division of Medicaid covers for all beneficiaries when prior authorized by the Utilization Management and Quality Improvement Organization (UM/QIO), the Division of Medicaid or designated entity, for rental up to three (3) months, then requires recertification when ordered by a physician who specializes in physical medicine, orthopedics, or neurology and the following criteria is met:

1. The beneficiary has a condition which causes unsteady gait and difficulty with ambulation,

2. The beneficiary has been evaluated by a physical therapist (PT) or occupational therapist (OT) not employed by the DME supplier,

3. The PT/OT evaluation report must be submitted with the request for prior approval and must document medical necessity and indicates the approximate length of time the beneficiary will need the gait trainer,

4. The beneficiary's functional level is such that he/she is trainable in use of a gait trainer,

5. The beneficiary has the potential to be ambulatory and is involved in therapy to regain or strengthen ambulatory function,

6. There is enough space in the beneficiary's home for the beneficiary to utilize gait trainer, and

7. There are no medical contraindications to use of the gait trainer.

Notes

23 Miss. Code. R. 209-1.25

42U.S.C. § 1395(m); Miss. Code Ann. §§ 43-13-117(17), 43-13-121.

Amended 9/1/2018