How Medicare Part B covers mobility equipment, what qualifies as a covered DME item, what documentation your doctor needs to provide, and how to navigate the process.
What Medicare Part B covers
Medicare Part B covers Durable Medical Equipment (DME) when the equipment is medically necessary, prescribed by a doctor, and used in your home. Mobility equipment falls under this category. Medicare typically covers 80% of the approved cost after you meet your Part B deductible — you pay the remaining 20%, unless you have a Medigap supplemental policy that covers the gap.
Medicare Part B — Mobility Equipment Coverage Overview
Coverage percentages are general guidance only.
Actual coverage depends on your specific plan, deductible status, and documentation. Always verify with Medicare at medicare.gov or call 1-800-MEDICARE before purchasing any device.
The 4 requirements for Medicare DME coverage
Medicare has four specific requirements that must all be met for a mobility device to be covered. Missing any one of them results in a denial:
- Medical necessity: Your doctor must document that the device is necessary for your medical condition — not just helpful or convenient. The documentation must explain why you cannot perform daily activities in the home without it.
- Home use: Medicare only covers equipment used inside your home. A scooter used primarily for community riding may not qualify even if you also use it at home.
- Physician prescription: A written order from a Medicare-enrolled physician or qualified non-physician practitioner. The prescription must include the diagnosis code (ICD-10), device type, and medical necessity justification.
- Medicare-enrolled supplier: You must purchase from a Medicare-enrolled DME supplier. OzzoCare does not currently process Medicare claims — if you require Medicare billing, ask your doctor for a referral to a Medicare-enrolled DME provider.
HCPCS codes for common mobility devices
Medicare uses Healthcare Common Procedure Coding System (HCPCS) codes to categorise DME. Knowing these codes helps you have a more productive conversation with your doctor and supplier.
| HCPCS code | Device type | Coverage notes |
|---|---|---|
| K0001 | Standard manual wheelchair | Most commonly covered basic wheelchair |
| K0003 | Lightweight wheelchair | Requires documentation of medical need for lighter weight |
| K0004 | High-strength lightweight wheelchair | For active users — requires additional documentation |
| K0005 | Ultra-lightweight wheelchair | Requires most extensive medical justification |
| K0800 | Power-operated vehicle (scooter) | Must document inability to operate manual chair |
| K0848–K0898 | Power wheelchairs — various classes | Most restrictive documentation requirements |
| E0143 | Wheeled walker (rollator) | Covered if medical necessity documented — less common |
Private insurance coverage
Private insurance coverage for mobility equipment varies significantly by plan. Most employer-sponsored and marketplace plans follow similar DME coverage frameworks to Medicare — requiring medical necessity, physician prescription, and in-network supplier use. Contact your insurer's DME department directly and ask for your plan's DME benefit schedule. Key questions: Is a prior authorisation required? What is my DME deductible? Is there a rental-before-purchase requirement?