Physicians with frail elderly patients will find their evaluation to determine whether they need mobility assistance requires more hoops and ladders, starting with a required face-to-face examination, which on its own "face" is a logical and widely understood medical standard of care. What the face-to-face exam requirement lacks is clarity and specificity as to what Medicare expects. One response gaining use across the country to streamline this newly complicated process, is a template developed by an advisory group of practicing physicians who treat the frail elderly and other patients with disabilities requiring mobility assistance. The guide has been adopted by the Texas Academy of Family Physicians and is spreading to other medical organizations as a straightforward way to organize the treating physician’s assessment so Medicare won’t reject the patient’s prescription several times for clarification. The guide isn’t an official document (Medicare hasn’t provided one,) but it does anticipate the kinds of criteria and conditions Medicare typically looks for, based on literally thousands of prescriptions, reviews, and appeals. It is intended to restore and preserve the treating physician’s professional judgment and reduce the probability of a bureaucratic "gotcha" by Medicare reviewers. As every physician who has prescribed a mobility device knows, there is often a clinical judgment call to make as to the extent of mobility needs that varies by patient. It is in that subjective area that the guide is intended to aid the physician’s evaluation.

There are two of these guides, depending on the patient’s mobility needs: one for the more modest "scooter", and one for a more sophisticated a power mobility device. We’ll be very interested to hear your own evaluation of this guide