23 Miss. Code. R. 209-1.45 - Walker

A. Medicaid defines a walker as an assistive device used to provide a wide base of support (BOS) for ambulation and stance.

1. It may be rigid or folding, rolling or a pickup type, and/or fixed or height adjustable.

2. The walker may have accessories to provide increased support.

B. Medicaid covers walkers 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 purchase amount, or purchase when indicated and must be ordered by a physician.

1. For a rigid or folding walker the following criteria must also be satisfied:

a) The beneficiary has a medical condition which causes impaired ambulation, but there is potential for the beneficiary to ambulate, and

b) There is a need for greater stability and security than can be provided by canes or crutches.

2. For a rigid pickup walker the same criteria apply, but the following specific criteria must also be met:

a) The beneficiary must be able to maintain balance while picking up the walker and moving it forward.

b) The beneficiary or caregiver must have means to transport a rigid walker.

c) Rigid walkers must provide a stable base of support:

d) For beneficiaries with impaired lower extremity weight-bearing ability such as spinal cord injury, cerebral palsy, congestive heart failure, stroke, post-operative conditions.

e) For beneficiaries with impaired balance during ambulation.

f) For ambulation training in newly braced children, adults in rehabilitation, and other diagnoses as medically necessary.

3. For wheeled walkers the same criteria applies but must meet also the following specific criteria:

a) The beneficiary must be able to maintain balance during ambulation with the rolling motion. It may be two (2) or four (4) wheeled.

b) Wheeled walkers are appropriate for beneficiaries who have difficulty using a rigid walker.

4. For folding walkers that are fixed, with or without wheels or seat, the same criteria from Rule 1.45 B. 1-3 above applies. Medicaid covers folding walkers that are push or pull types with two (2) or four (4) wheels.

5. For heavy duty walkers, multiple braking system, variable wheel resistance walkers the same criteria applies from Rule 1.45 B. 1-3 above, but must also meet the following criteria:

a) For larger or obese beneficiaries, or beneficiaries, who are unable to use a standard walker due to severe neurological disorders or restricted use of one (1) hand,

b) Beneficiaries whose gait patterns apply excessive force on the walker, and

c) Beneficiaries at risk of falling.

6. For attachments to walkers the same criteria applies from Rule 1.45 B. 1-3 above but must also meet the following:

a) When one (1) or both upper extremities are compromised due to surgical intervention, decreased range of motion, or contracture,

b) Provide a greater area of support,

c) When the beneficiary has decreased mobility and requires rest periods,

d) Seating attachments when beneficiaries who need rest periods during ambulation to conserve energy and maintain their endurance, and

e) Platform attachments for beneficiaries when one (1) or both upper extremities have decreased range of motion at the elbow, shoulder, or wrist that allows the beneficiary to grasp and hold onto the walker.

C. Medicaid covers for hand brakes when medically necessary.

Notes

23 Miss. Code. R. 209-1.45

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

Amended 9/1/2018