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Medicare Reimbursement Screening List For Durable Medical Equipment

Please select the letter that corresponds with the item of interest

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Item Coverage Status
Air Cleaners deny - environmental control equipment; not primarily medical
Air Conditioners deny - environmental control equipment; not primarily medical in nature
Air Fluidized Bed (See CIA 60-19)
Alternating Pressure Pad Covered if patient has, or is and highly susceptible to decubitus, Mattresses and Lambs Wool Pads ulcers, and patient's physician has specified that he will be supervising its use in connection with his course of treatment
Audible/Visible Signal (see Self-contained Pacemaker Monitor)
Augmentative Communication Device (see Communicator)
Bathtub Lifts deny-convenience item; hygienic equipment; not primarily medical in nature
Bathtub Seats deny-comfort or convenience item; hygienic equipment; not primarily medical in nature
Bead Bed (see CIA 60-19)
Bed Baths deny - hygienic equipment; not primarily medical in nature
Bed Lifter deny not primarily medical in nature
Bedboards not primarily medical in nature
Bed Pans (autoclave hospital type) covered if patient is bed confined
Bed Side Rails (see Hospital Beds)
Beds-Lounge deny-not a hospital bed; comfort or convenience item; not primarily medical in nature
Beds-Oscillating deny-institutional equipment; inappropriate for home use
Bidet (see toilet seats)
Blood Glucose Analyzer deny-unsuitable for home use
Blood Glucose Monitor covered if patient meets certain conditions
Braille Teaching Texts deny-educational equipment; not primarily medical in nature
Canes covered if patient's condition impairs ambulation
Carafes deny- convenience item; not primarily medical in nature
Catheters deny-nonresusable disposable supply
Commodes covered if patient is confined to bed or room
Communicator deny-convenience item; not primarily medical in nature
Continuous Passive Motion (CPM) Devices Continuous Passive Motion devices are covered by the Medicare program as durable medical equipment for patients who have received a total knee replacement. In order to qualify for such coverage, use of the device must commence within two days following surgery. In addition, coverage is limited to that portion of the three-week period following surgery during which the device is used in the patient's home.
Crutches covered if patient's condition impairs ambulation
Cushion Lift Power Seat (See Seat Lifts)
Dehumidifiers

deny-environmental control equipment; not primarily medical in nature

 
Diathermy Machines (standard and pulse wave types) deny-inappropriate for home use
Digital Electronic Pacemaker Monitor (See Self-contained Pacemaker Monitor)
Disposable Sheets and Bags deny-nonreusable disposable supplies
Elastic Stockings deny-nonreusable supply, not rental-type items
Electric Air Cleaners deny- (see Air cleaners)
Electric Hospital Beds (see hospital beds)
Electrostatic Machines deny -(see Air Cleaners and Air Conditioners)
Elevators deny-convenience item; not primarily medical in nature
Emesis Basins deny-convenience item; not primarily medical in nature
Esophageal Dilator deny-physician instrument; inappropriate for patient use
Exercise Equipment deny-not primarily medical in nature
Fabric Supports deny-nonreusable supplies; not rental type items
Face Masks (oxygen) covered if oxygen covered
Face Masks (surgical) deny-nonreusable disposable items
Flowmeter (see Medical Oxygen Regulators)
Fluidic Breathing Assistor (see IPPB Machines)
Fomentation Device (See Heating Pads)
Gel Floatation Pads and Mattresses (See alternating Pressure Pad Mattresses & Mattresses)
Grab Bars deny-self-help device, not primarily medical in nature
Heat and Massage Foam Cushion Pad deny-not primarily medical in nature; personal comfort item
Heating and Cooling Plants deny-environmental control equipment not primarily medical in nature
Heating Pads covered if the contractor's medical staff determines patient's medical condition is one for which the application of heat in the form of a heating pad is therapeutically effective
Heat Lamps covered if the contractor's medical staff determines patient's medical condition is one for which the application of heat in the form of a heat lamp is therapeutically effective
Hospital Beds (see CIA 60-18)
Hot Packs (see Heating Pads)
Humidifiers (oxygen) (see Oxygen Humidifiers)
Humidifiers deny-environmental control equipment; not medical in nature
Hydraulic Lift (see Patient Lifts)
Incontinent Pads deny-nonreusable supply, hygienic item
Infusion Pumps for external and implantable pumps; if the pump is used with an enternal or parenteral nutritional therapy system
Injectors (hypodermic jet pressure powered device for injection of insulin) deny-effectiveness not adequately demonstrated
IPPB Machines covered if patient's ability to breathe is severely impaired
Iron Lungs (see Ventilators)
Irrigating Kit deny-nonreusable supply, hygienic equipment
Lambs Wool Pads covered under same conditions as alternating pressure pads and mattresses
Leotards deny-(see Pressure Leotards)
Lymphedema Pumps covered (see CIA 60-16)
Massage devices deny-personal comfort items; not primarily medical in nature
Mattress covered only where hospital bed is medically necessary (Separate charge for replacement mattress should not be allowed where hospital bed with mattress is rented)
Medical Oxygen Regulators covered if patient's ability to breathe is severely impaired
Mobile Geriatric Chair (see rolling chairs)
Motorized Wheelchairs (see Wheelchairs (power operated))
Muscle Stimulators covered for certain conditions
Nebulizers covered if patient's ability to breathe is severely impaired
Oscillating Beds

deny-institutional equipment-inappropriate for home use
Overbed Tables deny-convenience item; not primarily medical in nature
Oxygen covered if the oxygen has been prescribed for use in connection with medically necessary durable medical equipment
Oxygen Humidifiers covered if a medical humidifier has been prescribed for use in connection with medically necessary durable equipment for purposes of moisturizing oxygen
Oxygen Regulators (Medical) (see Medical Oxygen Regulators)
Oxygen Tents (see CIA 60-4)
Paraffin Bath Units (Portable) (see Portable Paraffin Bath Units)
Paraffin Bath Units (standard) deny-institutional equipment; inappropriate for home use
Parallel Bars deny-support exercise equipment
Patient Lifts covered if contractor's medical staff determines patient's condition is such that periodic movement is necessary to effect improvement or to arrest or retard deterioration in his condition
Percussors covered for mobilizing respiratory tract secretions in patient's with chronic obstructive lung disease, chronic bronchitis, or emphysema, when patient or operator of powered percussor has received appropriate training by a physician of therapist, and no one competent to administer manual therapy is available
Portable Oxygen Systems:

1. Regulated
(adjustable flow rate)


2. Preset
(flow rate not adjustable)

covered when the patient has undergone a successful trial period of paraffin therapy ordered by a physician and the patient's condition

deny-emergency, first aid, or precautionary equipment essentially not therapeutic in nature.
Portable Room Heaters deny-environmental control equipment; not primarily medical in nature
Portable Whirlpool pumps deny-not primarily medical in nature; personal comfort item
Postural Drainage Boards covered if patient has a chronic pulmonary condition
Preset Portable Oxygen Units deny-emergency, first aid or precautionary equipment essentially not therapeutic in nature
Pressure Leotards deny - non reusable supply, not rental type item
Pulse Tachometer deny-not reasonable or necessary for monitoring pulse of homebound patient with or without a cardiac pacemaker.
Quad-Canes (see walkers)
Raised Toilet Seats deny-convenience item; hygienic equipment not primarily medical in nature
Reflectance Colorimeters (see Blood Glucose Analyzers)
Respirator (see Ventilators)
Rolling Chairs Covered if the contractor's medical staff determines that the patient's condition is such that there is a medical need for this item and it has been prescribed by the patient's physician in lieu of a wheelchair. Coverage is limited to those rollabout chairs having casters of at least 5 inches in diameter and specifically designed to meet the needs of ill, injured or otherwise impaired individuals.
Safety Rollers (see CIA-60-15)
Sauna Baths deny not medical in nature personal comfort items
Seat Lift covered under the conditions specified in 60-8 refer all to medical staff for this determination
Self-contained Pacemaker covered when prescribed by a physician for a patient with a cardiac pacemaker
Sitz Bath covered if the contractor's medical staff determines patient has an infection or injury of the perineal area and the item has been prescribed by the patient's physician as a part of his planned regimen of treatment in the patient's home
Spare Tanks of Oxygen deny convenience or precautionary supply
Speech Teaching Machine deny-education equipment, not primarily medical in nature
Stairway Elevators deny (see elevators)
Standing Table deny - convenience item not primarily medical in nature
Steam Packs These packs are covered under the same condition as a heating pad
Suction Machine covered if the contractor's medical staff determines that the machine specified on the claim is medically required and appropriate supervision
Support Hose deny (see Fabric Supports)
Surgical Leggings deny nonreusable supply; not rental type item
Telephone Arms deny-convenience item; not medical in nature
Toilet Seats deny not medical equipment
Traction Equipment Covered if patient has orthopedic impairment requiring traction equipment which prevents ambulation during the period of use (Consider covering devices usable during ambulation; e.g., cervical traction collar, under the brace provision)
Trapeze Bars Covered if patient is bed confined and the patient needs a trapeze bar to sit up because of respiratory condition, to change body position for other medical reasons, or to get in and out of bed
Treadmill Exerciser deny -excercise equipment; not primarily medical in nature
Ultraviolet Cabinet covered for selected patients with generalized intractable psoriasis. Using appropriate consultation, the intermediaries should determine whether medical and other factors justify treatment at home rather that at alternative sites, e.g., outpatient department of a hospital
Urinals (autoclavable hospital type) covered if patient is bed confined
Vaporizes covered if patient has a respiratory illness
Ventilators covered for treatment of neuromuscular diseases, thoracic restrictive diseases and chronic respiratory failure consequent to chronic obstructive pulmonary disease. Includes both positive and negative pressure types.
Walkers covered if patients condition impairs ambulation
Water and Pressure Pads (see Alternating Pressure Pads and Mattresses
Wheelchairs covered if patient's condition is such that without the use of a wheel chair he would be otherwise be bed-or chair- confined; an individual may qualify for a wheel chair and still be considered bed confined.
Wheelchair (power operated) and wheelchair with other special features Covered if patient's condition is such that a wheelchair is and medically necessary and the patient is unable to operate the wheelchair manually. Any claim involving a power wheelchair or a wheel chair with other special features should be referred for medical consultation since payment for the special features is limited to those which are medically required because of the patient's condition.
Whirlpool Bath Equipment covered if patient is homebound and has a condition for which the whirlpool bath can be expected to provide substantial therapeutic benefit justifying such a condition, payment is restricted to the cost of providing the services elsewhere, e.g., an outpatient department of a participating hospital, if that alternative is less costly. In all cases, refer claim to medical staff for a determination.
Whirlpool pumps deny -(see Portable Whirlpool pumps)
White Cane deny