Provider Alert! Updated Wheelchair Guidelines

Provider Alert!

Provider Alert! Updated Wheelchair Guidelines

Call to action: The purchase of a wheelchair is a benefit every five years, with the following guidelines:

For current members who are twelve years of age and younger: The wheelchair frame must allow for at least a 3-inch growth potential in both width and depth.

For current members who are 13 through 17 years of age: The wheelchair frame must allow for at least a 2 inch growth potential in both width and depth.

For current members who are 18 years of age and older. The wheelchair frame must allow for at least a 1-inch growth potential in depth and 2 inches in width.

For wheelchair repair request Texas Children’s Health Plan will follow the criteria outlined in the most recent Texas Medicaid Provider Procedures Manual

How this impacts providers: Providers should review and understand the complete wheelchair guidelines available here:
https://www.texaschildrenshealthplan.org/for-providers/provider-resources/prior-authorization-information

Next steps for providers: Providers should ensure their understanding of the guidelines and coordinate with their staff.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers

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