What is the face-to-face exam for Medicare power mobility?

The face-to-face exam is a clinical visit where a physician or qualified practitioner documents the individual’s mobility limitations, functional impact, and medical conditions supporting the need for power mobility, typically before equipment is ordered.

What should the face-to-face exam include for a power wheelchair request?

The documentation should clearly describe mobility limitations, how they affect daily activities, why the need exists inside the home, and diagnoses that support mobility impairment, while aligning with therapy evaluation findings.

What kinds of face-to-face notes commonly lead to denials?

Notes that are vague, copied from unrelated visits, focused only on community mobility, or missing clear functional impact and diagnosis alignment can trigger denials or requests for more information.

Does the face-to-face exam have to match the therapy evaluation?

Yes. Medicare reviews commonly look for consistency across physician notes, therapy evaluation, and the order. Misalignment can weaken medical necessity, even when the recommendation is clinically appropriate.

When should the face-to-face exam occur in the process?

It should occur early in the process and typically before the order is finalized, so the documentation timeline and clinical record support the request without gaps or conflicts.

Group 2 vs Group 3 Power Wheelchairs: Medicare Coverage Differences

Viva Las Mobility
Feb 27
1 min read

Understanding the difference between Group 2 and Group 3 power wheelchairs is essential for both clinicians and patients navigating Medicare coverage.

While both are power mobility devices, coverage requirements and clinical expectations differ significantly.

Two power wheelchairs labeled Group 2 (blue) and Group 3 (red) on a split blue-orange background. Text: Medicare Coverage Differences.

Group 2 Power Wheelchairs

Typically appropriate for individuals who:

Require basic power mobility
Do not need advanced electronics
Have stable postural needs

Coverage requirements are less extensive but still require medical necessity.

Group 3 Power Wheelchairs

Group 3 chairs are classified as Complex Rehabilitation Technology and are intended for individuals with:

Progressive or severe neurological conditions
Significant postural support needs
Need for power seating functions
Long-term or permanent mobility impairments

Medicare Documentation Differences

Requirement	Group 2	Group 3
Therapist evaluation	Recommended	Required
Advanced electronics	No	Yes
Custom seating	Limited	Often required
Documentation depth	Moderate	Extensive

Choosing the Appropriate Level

Prescribing Group 3 equipment requires clear justification that Group 2 options cannot meet the user’s medical and functional needs.

Final Thought

The right wheelchair is not about complexity — it’s about clinical appropriateness supported by strong documentation.

👉 Explore related topics on our Frequently Asked Questions and Custom Seating Systems resources.