Community First Health Plans is sharing information from the Texas Health and Human Services Commission (HHSC) regarding wheeled mobility systems and related Provider resources.
TMHP Training Resource
A TMHP learning module is available to help Providers understand Texas Medicaid requirements for requesting wheeled mobility systems. The training is available through the TMHP Learning Management System (LMS).
Repair and Reimbursement Reminders
Providers should be aware of the following Texas Medicaid requirements:
- Modifications, adjustments, and repairs made within the first six months after delivery of a wheeled mobility system are considered part of the purchase price and are not separately reimbursable.
- Repairs to client-owned equipment may be separately reimbursed after six months when supported by documentation of medical necessity.
- A seating assessment is not required when requesting repairs to a wheeled mobility system.
Additional Considerations
- Rental equipment should be offered during the repair period when appropriate.
- Members may use non-emergency medical transportation (NEMT) services to travel to a wheelchair clinic.
Additional Information
Providers are strongly encouraged to review the full HHSC notice, TMHP training module, and applicable Texas Medicaid policy resources for complete details and requirements.
Policy Documents
- UMCM 16.9 – Durable Medical Equipment (DME)
- UMCM 16.4 – Nonemergency Medical Transportation (NEMT) Services Handbook
- TMPPM, Section 2.2.2.1 Modifications, Adjustments, and Repairs, Vol. 2, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook
Provider Notification and Learning Management System Links:
- https://www.tmhp.com/news/2025-03-14-clarification-wheeled-mobility-system-benefit-information-tmppm
- https://www.tmhp.com/news/2025-02-04-new-training-module-available-dme-wheeled-mobility-systems
- Welcome to the TMHP LMS
- Log in with username and password, on the Featured Courses page, enter ‘DME Program’ in the search function
- Select ‘DME Program’
- Scroll down to ‘Content’ and select ‘DME Program eLearning’
- Select the training titled ‘DME Medicaid Approved Wheelchairs’ to begin
Action:
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.
To access all Provider alerts:
- Log into the Community First Provider Portal
- Go to CommunityFirstHealthPlans.com/Provider-News
- Sign up for the Community First Provider eNewsletter