Minnesota Health Care Programs (MHCP) revised authorization and billing requirements for mobility devices and accessories effective June 1, 2025.
MHCP is changing authorization from always to sometimes required for most manual wheelchairs, regardless of the device being requested for purchase or rental. The following devices only require authorization for excess quantities or as backup devices for power wheelchair users:
- Standard wheelchairs (HCPCS code K0001)
- Standard hemi wheelchairs (K0002)
- Lightweight wheelchairs (K0003)
- High-strength, lightweight wheelchairs (K0004)
- Heavy-duty wheelchairs (K0006)
- Extra-heavy-duty wheelchairs (K0007)
- Rollabout chairs (E1031)
- Transport chairs (E1037 to E1039)
MHCP requires authorization for all purchases and rentals of the following mobility devices:
- Ultralightweight manual wheelchairs (HCPCS code K0005)
- Tilt-in-space manual wheelchairs (E1161)
- Pediatric-size wheelchairs (E1229, E1231 to E1239)
- Custom or other manual wheelchairs (K0008, K0009)Power-operated vehicles (K0800 to K0802, K0806 to K0808)
- Power wheelchairs (K0813 to K0891)
Previously, the Mobility Devices section of the MHCP Provider Manual instructed providers to list all HCPCS codes on authorization requests for purchase, even if an individual HCPCS code does not require authorization. We have updated language for listing accessories. Providers should continue to document medical necessity for all items to be dispensed in the medical record, but only request authorization if the individual HCPCS code requires authorization.
We revised information under the Authorization heading of the Mobility Devices section of the MHCP Provider Manual to instruct providers to list all options and accessories, the specific medical justification for the mobility device, and each option or accessory in the medical record. Only include devices and accessories on authorization requests that always require authorization or for excess quantities. The following items always require authorization:
- One-arm drive attachments (HCPCS code E0958)
- Push-rim activated power assist systems (E0986)
- Power tilt seating systems (E1002)
- Power recline seating systems (E1003 to E1005)
- Power tilt and recline seating systems (E1006 to E1008)
- Mechanical leg elevation systems (E1009)
- Power leg elevation systems (E1010, E1012)
- Gimbaled ventilator trays (E1030)
- Multi-positional transfer systems (E1035, E1036)
- Gear reduction drive wheelchairs (E2227)
- Wheel braking systems (E2228)
- Manual standing systems (E2230)
- Power seat elevation systems (E2298)
- Power standing systems (E2301)
- Electronic components for motors controlled by interfaces (E2310, E2311)
- Alternative interface devices (E2313, E2321 to E2331, E2373, E2399)
- Custom fabricated seating systems (E2609, E2617)
- Powered seat cushions (E2610)
- Mobile arm supports and additions (E2626 to E2623)
Previously, custom fabricated seating systems required authorization if the submitted charge was over $1,200. Authorization is now required always for HCPCS codes E2609 and E2617, regardless of the total amount. Powered seat cushions, which did not require authorization, also now always require authorization.
Authorization is required for HCPCS code K0108 when the submitted charge is $400 or more. Authorization is no longer required for any individual part that costs $400 or more. Authorization is only required if the individual HCPCS code always requires authorization or for excess quantities.
Under the Billing heading of the Mobility Devices section of the MHCP Provider Manual, we instruct providers to document which accessories and options are included with a mobility device. Do not bill MHCP for standard items included at the time of the initial issue of a wheelchair. Bill two claims, one for HCPCS codes that do not require authorization, and one for HCPCS codes that do require authorization.
Review the Mobility Devices section of the MHCP Provider Manual and the Medical Supply Coverage Guide (PDF) for information on MHCP authorization requirements and quantity limits by HCPCS code. Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 6/17/25)