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.