Section 182-543-4100 - Covered - Wheelchairs - Manual The medicaid agency covers the rental or purchase of a manual wheelchair for a home client who is nonambulatory or has limited mobility and requires a wheelchair to participate in normal daily activities. For clients who reside in a skilled nursing facility, see WAC 182-543-5700.
(1) The agency determines the type of manual wheelchair for a home client as follows: (a) A standard wheelchair if the client's medical condition requires the client to have a wheelchair to participate in normal daily activities;(b) A standard lightweight wheelchair if the client's medical condition is such that the client: (i) Cannot self-propel a standard weight wheelchair; or (ii) Requires custom modifications that cannot be provided on a standard weight wheelchair.(c) A high-strength, lightweight wheelchair for a client: (i) Whose medical condition is such that the client cannot self-propel a lightweight or standard weight wheelchair; or(ii) Requires custom modifications that cannot be provided on a standard weight or lightweight wheelchair.(d) A heavy duty wheelchair for a client who requires a specifically manufactured wheelchair designed to:(i) Support a person weighing three hundred pounds or over; or(ii) Accommodate a seat width up to twenty-two inches wide (not to be confused with custom heavy duty wheelchairs).(e) A custom heavy duty wheelchair for a client who requires a specifically manufactured wheelchair designed to: (i) Support a person weighing three hundred pounds or over; or(ii) Accommodate a seat width over twenty-two inches wide.(f) A rigid wheelchair for a client: (i) With a medical condition that involves severe upper extremity weakness;(ii) Who has a high level of activity; and(iii) Who is unable to self-propel any of the above categories of wheelchair.(g) A custom manufactured wheelchair for a client with a medical condition requiring wheelchair customization that cannot be obtained on any of the categories of wheelchairs listed in this section.(h) Pediatric wheelchairs/positioning strollers having a narrower seat and shorter depths more suited to pediatric patients, usually adaptable to modifications for a growing child.(2) The agency pays for both a manual wheelchair and a power-drive wheelchair only for noninstitutionalized clients in limited circumstances. See WAC 182-543-4200(5).Wash. Admin. Code § 182-543-4100
Amended by WSR 14-08-035, filed 3/25/14, effective 4/25/201411-14-075, recodified as §182-543-4100, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.04.050. 11-14-052, § 388-543-4100, filed 6/29/11, effective 8/1/11.