DME - Durable Medical Equipment
Durable Medical Equipment (DME) is equipment which meets all of the following requirements:
Can withstand repeated use
Is primarily and customarily used to serve a medical purpose
Is generally not useful to a person in the absence of an illness or injury
Is appropriate for use in the home
Often a physician will prescribe special equipment for use by a beneficiary in his/her home. The equipment may provide therapeutic benefits or enable the beneficiary to perform certain tasks that s/he is unable to undertake due to certain medical conditions and/or illnesses.
Services or supplies are considered medically necessary if they:
Are proper and needed for diagnosis, or treatment of your medical condition.
Are provided for the diagnosis, direct care, and treatment of your medical condition.
Meet the standards of good medical practice in the medical community of your local area.
Are not mainly for the convenience of you or your doctor.
Medicare Part B helps pay for durable medical equipment such as oxygen equipment, wheelchairs, walkers, and other medically necessary equipment that your doctor prescribes to use in your home.
Medicare pays for different kinds of durable medical equipment in different ways.
Certain covered items can be reimbursed by Medicare only if the doctor has furnished the supplier with a detailed written prescription for the item before delivery. Most supplies require a prescription to be covered by Medicare
Important Note: If the item is prescribed after the purchase date, the claim will be denied
A Certificate of Medical Necessity (CMN) is a form required by Medicare authorizing the use of certain durable medical items and equipment prescribed by a physician. This form is to be completed by your doctor or the doctor's employee. We will coordinate with your doctor to see that all the necessary information is submitted to Medicare. A change in prescription and/or a change in your condition requires that an updated certificate be completed and submitted.
The following items require a CMN: