Document Type
Presentation
Publication Date
4-2026
Faculty Mentor
Corey Morrow
Abstract
The wheelchair acquisition process is complicated and requires an interdisciplinary team of Assistive Technology Professionals (ATP) and either Occupational Therapists (OT) or Physical Therapists (PT). Without a proper mobility device, many wheelchair users report frustration due to decreased participation in work, school, medical appointments, and social events. Improper documentation of specific wheelchair needs contributes to payment authorization denials, causing long delays in the approval process and the timeliness of patients receiving their devices. (Nancy R. Mudrick, April, 2025). According to the 2024 reporting period for Centers for Medicaid and Medicare Services (CMS), “insufficient documentation accounted for 79.7% of improper payments for manual wheelchairs” (CMS.gov, 2026).
The purpose of this capstone was to streamline wheelchair evaluation documentation for home health PT or OT clinicians in alignment with CMS guidelines, improving the timeliness of wheelchair provision. Specifically, the goals were to 1) develop universal specialty evaluation templates for manual and tilt-in-space wheelchairs, 2) increase therapist and ATP collaboration, and 3) dispense the deliverables to clinicians to enhance the wheelchair provision process.
The project improved the efficiency of the evaluation process by reducing the average evaluation time from 90 minutes to approximately 45 minutes in the home health setting. This reduction allowed clinicians additional time to focus on completing the specialty evaluation templates, leading to decreased documentation time. A future objective stemming from this capstone is to decrease wheelchair denials, and in return, decrease delays in the approval process in the home health setting.
The qualitative feedback gathered from home health clinicians indicated that the use of standardized verbiage was highly beneficial, particularly due to clinicians’ limited familiarity with wheelchair-specific terminology. Additionally, the ability to pre-fill the template contributed to reduced documentation time. Most importantly, clinicians reported that the template created a less stressful and more streamlined experience when completing wheelchair evaluations. Overall, this capstone demonstrated a positive impact on home health PTs and OTs completing wheelchair specialty evaluations while improving timely wheelchair delivery for mobility device users.
Resources
CMS.gov. (2026, 02/11/2026). Manual Wheelchairs. Centers for Medicare & Medicaid Services. https://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/manual-wheelchairs
Nancy R. Mudrick, P., Mary Lou Breslin, MA, Donna H. Odierna, DrPh, MS,. (April, 2025). "Expensive, frustrating, demoralizing" Wheelchair users' recent device purchase experiences, Mobility Device User Survey: A Full Report. Disability Rights Education & Defense Fund.
Recommended Citation
Morales, Alexandria, "Aligning Clinical Documentation with Payer Requirements to Improve Wheelchair Access" (2026). Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium. 96.
https://medica-musc.researchcommons.org/muscotd-elotd/96