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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.

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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:

  • Oxygen

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