A transport chair is covered as an alternative to a standard manual W/C if:

- Beneficiary has mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) such as toileting, feeding, dressing, grooming, and bathing in customary location in the home:

Prevents the beneficiary from accomplishing an MRADL entirely; OR

Places beneficiary at a reasonably determined risk secondary to the attempts to perform an MRADL; OR

Prevents beneficiary from completing an MRADL within a reasonable amount of time; AND

- Mobility limitation cannot be sufficiently and safely resolved by use of appropriately fitted can or walker; AND

- Home provides adequate access between rooms, maneuvering space and surfaces fore use of the wheelchair that is provided; AND

- Use of a manual wheelchair will significantly improve the beneficiary’s ability to participate in MRADLs and beneficiary will use it on a regular basis; AND

- Beneficiary has not expressed an unwillingness to use the manual wheelchair; AND

- Beneficiary has a caregiver who is available, willing and able to provide assistance with the wheelchair.