Hospital Beds

Medicare Qualifications:

Coverage is considered for a fixed-height hospital bed when at least one of the following are met:

• Has a medical condition which requires positioning of the body in ways not feasible with an ordinary bed.
• Patient requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain.
• Requires the head of the bed to be elevated more than 30 degrees most of the time because of congestive heart failure, chronic pulmonary disease, or problems with aspiration.
• Requires traction equipment that can only be attached to a hospital bed.

Coverage is considered for a variable height bed if the beneficiary meets one of the criteria for a fixed height hospital bed AND requires a bed height different than a fixed height hospital bed to permit transfers to a chair, wheelchair or standing position.

Coverage is considered for a semi-electric hospital bed if the beneficiary meets one of the criteria for a fixed height bed and requires frequent changes in body position and/or has an immediate need for a change in body position.

Coverage is considered for a heavy duty extra wide hospital bed if the beneficiary meets one of the criteria for a fixed height bed and the beneficiary’s weight exceeds 350 pounds, but does not exceed 600 pounds.

Coverage is considered for an extra heavy duty hospital bed if the beneficiary meets one of the criteria for a fixed height bed and the beneficiary’s weight exceeds 600 pounds.

A total electric hospital bed is not covered; the height adjustment feature is a convenience feature, and will be denied as not reasonable and necessary.

Required Documentation for Medicare

1. Prescription – Must be signed and dated by treating physician.
2. Detailed Written Order – Signed and dated by the treating physician (prior to delivery).
3. Chart Notes – Including information stating why a hospital bed is medically necessary (must comply with Qualifications listed above).
4. Face to Face Evaluation – Completed Face to Face evaluation from physician.

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Hospital Beds LCD