A Dispensing Order written by the treating physician must be sent to us before an item can be supplied. Some items require a Detailed Written Order (DWO) prior to delivery or a Certificate of Medical Necessity (CMN).
A Dispensing Order (prescription) must include:
A Written Order must include:
Medicare Part B helps pay for durable medical equipment, including:
Durable medical equipment, such as wheelchairs, are covered only when prescribed by a doctor and the coverage criteria is meet. For most of the above equipment there are specific criteria that must be met. Please call to understand the criteria for Medicare coverage.
Medicare will pay for the rental of the equipment for 13 continuous months of use with the exclusion of oxygen equipment which rents for 36 months. After Medicare has paid for 13 months of continuous use on capped rental equipment, the supplier shall transfer the title to the beneficiary. Oxygen equipment does not transfer title to the beneficiary and the supplier is required to maintain the equipment until the 60th month under Medicare guidelines. After the 60th month the beneficiary can opt for new equipment and a new 36 month rental period begins.
Medicare considers hospital beds as a “capped rental” item. This means that Medicare will rent the bed for 13 monthly payments after which it will “cap out” and the beneficiary will own the bed. Medicare does not consider a full-electric hospital bed, deluxe bed, or a luxury bed to be medically necessary. If your physician feels a hospital bed is medically necessary, they must chart in the patient notes that they feel it is necessary and the reason why it is necessary verses a traditional bed.
Medicare considers wheelchairs as a “capped rental” item. This means that Medicare will rent the wheelchair for 13 monthly payments after which it will “cap out” and the beneficiary will own the wheelchair. Medicare does not consider a lightweight, ultra-lightweight, heavy duty, or modified chair medically necessary without doctors notes that support the medical need for such add-ons. If your physician feels a wheelchair is medically necessary, they must chart in the patient notes that they feel it is necessary and the reason why it is necessary verses a cane, walker or crutch.
A power wheelchair may be covered when all of the following criteria are met:
A patient who requires a power wheelchair usually is totally non-ambulatory and has severe weakness of the upper extremities due to a neurological or muscular disease/condition. If the documentation does not support the medical necessity of a power wheelchair it will be denied as not medically necessary. For the correct steps to see if you qualify a power wheelchair please call us for a free guide.
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