How will I know if I can buy durable medical equipment or whether Medicare will only pay for me to rent it?
If your supplier is a Medicare-enrolled supplier, they will know whether Medicare allows you to buy a particular kind of durable medical equipment,or just pays for you to rent it. Medicare pays for most durable medical equipment on a rental basis. Medicare only purchases inexpensive or routinely purchased items, such as canes; power wheelchairs; and, in rare cases, items that must be made specifically for you.
Buying equipment
If you own Medicare-covered durable medical equipment and other devices, Medicare may also cover repairs and replacement parts. Medicare will pay 80% of the Medicare-approved amount for purchase of the item. Medicare will also pay 80% of the Medicare-approved amount (up to the cost of replacing the item)for repairs. You pay the other 20%. Your costs may be higher if the supplier doesn’t accept assignment. Note:The equipment you buy may be replaced if it’s lost,stolen, damaged beyond repair, or used for more than the reasonable useful lifetime of the equipment.
Renting equipment
If you rent durable medical equipment and other devices,Medicare makes monthly payments for use of the equipment. The rules for how long monthly payments continue vary based on the type of equipment. Total rental payments for inexpensive or routinely purchased items are limited to the fee Medicare sets to purchase the item. If you will need these items for more than a few months, you may decide to purchase these items rather than rent them. Monthly payments for frequently serviced items, such as ventilators, are made as long as the equipment is medically necessary. The payment rules for other types of rented equipment,called “capped rental items,” are on page 10. Medicare will pay80% of the Medicare-approved amount each month for use of these items. You pay the other 20% after you pay the Medicare Part B deductible ($135 in 2009).The supplier will pick up the equipment when you no longer need it. Any costs for repairs or replacement parts for the rented equipment are the supplier’s responsibility.
The supplier will also pick up the rented equipment if it needs repairs. You don’t have to bring the rented equipment back to the supplier.
Durable medical equipment (DME ) medical billing. How to do billing for Medicare and what equipment covered by Medicare. DME Modifiers and CPT codes.
Tuesday, December 7, 2010
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