Sample Letters of Medical Necessity for the Rifton Pacer Gait Trainer

Since the new Pacer became available we have been receiving questions regarding funding for this device. Evolving from the previous model of Pacer, the new Pacer now offers many new additional features including a dynamic upper frame, multi-positioning saddle, arm platforms, utility base (with bigger wheels for rough, outdoor  surfaces), and a treadmill base option. To obtain funding, each unique feature and function of the Rifton Pacer will need to be justified as medically necessary. Providing justification for these new features may make the difference for those states where we were seeing too many denials for our old Pacer.

As guidelines and a starting point, here are two sample letters of medical necessity for the Rifton Pacer. One justifies funding in a school-based practice setting; the other, for an adult client in homecare.