Medicare Certification of Medical Necessity

The Centers for Medicare & Medicaid Services (CMS) has issue an interim final rule that has implement provisions in the Medicare Modernization Act (MMA) affecting power operated vehicles (or scooters) and power wheelchairs. The interim final rule also describes the clinical documentation that must be submitted along with a written prescription before a supplier may deliver power mobility equipment to a beneficiary. This interim final rule is part of a comprehensive overhaul of Medicare policies affecting power mobility devices (PMD) that encompasses coverage, prescribing, coding, payment and claims documentation for these devices. The goal is to ensure that beneficiaries who need assistance with mobility have access to appropriate technologies, and that Medicare pays appropriately for these devices.

The following forms are here for you to download and print.  Take the appropriate form to your primary healthcare provider and have them fill it out.

When the forms are completed, bring them in to Florida Mobility, or have the doctor fax them to us with your prescription for the items ordered.

Updated forms coming soon.


Downtown (Service Center)
3559 S Orange Ave
Orlando, FL 32806
Fax: (407) 858-0439

Hours: Mon-Fri
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V.A. Repair Center

"Florida's REAL Scooter Store"
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South (Medical Supplies)
8451 S John Young Parkway Orlando, FL 32819
Fax: (407) 363-4475

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Sat: 10:00am - 4:00pm