This information is presented to serve as a resource to both end users and health care professionals to assist in finding answers to questions related to the access of Durable Medical Equipment (DME) through Medicare Part B. Some of the information you can expect to find within our website include:
What you need to know
Medicare policy, equipment qualifications and documentation requirements are absolute and must be satisfied, in full. If the beneficiary does not meet ALL required criteria and/or if the clinical documentation received does not support that the criteria has been met then other funding arrangements will have to be made before equipment can be provided.
As a condition to receive payment, per Section 6407 of the Affordable Care Act that was implemented July 1, 2013, it is required that certain DME items require a Face-to-Face evaluation with the beneficiary. It is also required that the physician document that the encounter for the item did occur and within the allotted time frame, 6 months of the Detailed Written Order. The face-to-face may be performed by physician, PA, NP or CNS, but upon completion the face-to-face must be approved and signed by the physician.
Medicare has strict guidelines and policies, some of which are:
For a detailed list of all Qualifications and Required Documentation, Please click on the requesting item below.