Medicare Requirements
Medicare guidelines are managed by the Centers for Medicare and Medicaid (CMS). It can be confusing, so please call us and we can review your specific situation to see if you qualify for the Durable Medical Equipment your doctor has prescribed for you. 603-889-7220
Medicare Documentation Requirements for Durable Medical Equipment
Item |
Limitations |
Documentation |
Cane |
Every 5 years, no previous walker, manual wheelchair, power wheelchair or scooter |
Prescription with relevant diagnosis, except pain. |
Walker |
Every 5 years, no previous manual wheel chair, power wheel chair or scooter |
Prescription with relevant diagnosis except pain. |
Rollator |
Same as walker |
Same as walker. |
Manual Wheelchair** |
Every 5 years, no previous power wheel chair or scooter. |
Prescription/Mobility Evaluation form, Face to Face. |
Nebulizer** |
Every 5 years (rent to own) |
Prescription with relevant diagnosis other than wheezing or generic diagnosis plus Office Notes from Doctor. |
Hospital Bed** |
Every 5 years |
Prescription/Hospital bed CMN/Only diagnoses of heart, lung or aspiration, plus Face to Face. |
Braces (back, knee, wrist supports/AB binder) |
Not covered unless rigid |
Rigid brace with prescription. Soft braces are not covered. |
Braces (Wrist) |
Every 2 years |
Prescription with relevant diagnosis, except pain. |
**Face-to-face requirements effective 2013.