8 Element Order Required for Medicaire (Insurance ) Authorization for a Mobility Scooter

Once the Face to Face visit is complete, a Doctor or Nurse Practitioner must write a script with the following information:

1. Name of Patient
2. Write: “Scooter” as prescribed item
3. Write : “Date of Face to Face Visit: XX/XX/XX” – The words “Face to Face” must appear on the script
4. Write: “Length of Need: 99” – Meaning the length of need is for lifetime
5. Diagnosis Codes pertaining to receiving a scooter
6. Doctor’s or Nurse Practitioner’s Signature (no rubber stamps)
7. The Signature has to be dated (Yes, there are two dates on the script)
8. Doctor’s or Nurse Practitioner’s NPI number

This information is for educational purposes only. Contact your local DME dealer.

Download an Example of an 8 Element Script for a Mobility Scooter