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Elizabeth M. Whitehorn, Director

Provider Notice issued 02/05/2026

Prior Approval Required on All Wheelchair Repairs Greater Than $1,500.00 Effective March 1, 2026

To:
 Enrolled Durable Medical Equipment and Supplies Providers  
​Date: ​February 5, 2026
​Re:
 Prior Approval Required on All Wheelchair Repairs Greater Than $1,500.00 Effective March 1, 2026

This notice informs durable medical equipment (DME) providers of a change in state law PA 104-0324 that affects prior approvals for wheelchair repairs. 

Effective March 1, 2026, the threshold amount required for prior approval of wheelchair repairs has changed. If the repair cost exceeds $1,500, previously $750.00, prior approval will be required. DME providers may not divide wheelchair repairs into separate claims for the purpose of staying under the $1,500 threshold. HFS will be monitoring DME billing claims for compliance on this issue.

Questions regarding fee-for-service customer repair approvals may be directed to a DME billing consultant within the Bureau of Professional and Ancillary Services at 1-877-782-5565 Option 3, then Option 2. Questions regarding managed care plan (MCO) customer repair approvals may be directed to the applicable MCO.

 

Laura Phelan, Administrator 
Division of Medical Programs