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Medicare Coverage

Specific Coverage Requirements for DME

Most durable medical equipment has specific eligibility requirements. For example, a bedside commode is covered only if the person is bed-or room-confined. In some instances, coverage of certain DME items will not be covered simultaneously. A wheelchair and a walker will be not covered at the same time, and a seat lift mechanism that helps a person exit a chair will not be covered if a person uses a wheelchair.

To learn more about the exact criteria that a person must meet in order to qualify for a specific item, please visit Medicare's website.
 http://www.medicare.gov/.

Physician's Prescription

All items submitted for Medicare payment require a doctor's prescription, also referred to as a Certificate of Medical Necessity (CMN).

Covered items for eligible patients

  • Alternating Pressure Pad
  • Bead Bath
  • Bed Pan
  • Cane
  • Commode
  • Heating Pad
  • Heat Lamp
  • Hospital Bed
  • Mattress (covered only with hospital bed)
  • Mobile Geriatric Chair
  • Pressure Relieving Surfaces (pads & mattresses)
  • Seat Lift
  • Sitz Bath & Whirlpool Bath Equipment
  • Trapeze Bar
  • Walker
  • Wheelchair (manual & powered)

Noncovered items for eligible patients

  • Air cleaner
  • Augmentative Communication Device
  • Bathtub Lift
  • Bathtub Seat & Transfer Bench
  • Bed Bath
  • Environmental Control Equipment
  • Grab Bar
  • Overbed Table
  • Stair Lift
  • Telephone Alert System
  • Toilet Safety Frame
  • Toilet Seat
  • Whirlpool Pump
© Weill Medical College of Cornell University
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