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U.S. Dept. of Health & Human Services
Power Mobility Device Face-to-Face Examination Checklist
The Centers for Medicare & Medicaid Services (CMS) is issuing this article as solely an
educational guide to improve compliance with documentation requirements for the face-to-face
examination that occurs prior to the physician or treating practitioner ordering a PMD for their
Medicare patients. The article presents a checklist, which is a tool that providers may wish to use
for this examination, in addition to some helpful tips to help providers and suppliers avoid denial of
their PMD claims. The use of this guide is not mandatory and does not ensure Medicare
payment for a PMD, even if signed and dated.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 02, 2011
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.
Date Published: 6/4/2021
