Thursday, April 28, 2016

What is Durable Medical Equipment


Definitions  Durable Medical Equipment (DME)


DME is covered under Part B as a medical or other health service (§1861(s)(6) of the Social Security Act [the Act]) and is equipment that:

a. Can withstand repeated use;

b. Is primarily and customarily used to serve a medical purpose;

c. Generally is not useful to a person in the absence of an illness or injury; and

d. Is appropriate for use in the home.

All requirements of the definition must be met before an item can be considered to be durable medical equipment.

A SNF normally is not considered a beneficiary's home. However, a SNF can be considered a beneficiary's home for Method II home dialysis purposes. See the Program Integrity Manual, Chapter 5, for guidelines on when a SNF may be considered a home.


For detailed coverage requirements (including definitions and discussion) associated with the following DME terms and circumstances see the Medicare Benefit Policy Manual, Chapter 15:

• "Durability"

• "Medical Equipment"

• "Equipment Presumptively Medical"

• "Equipment Presumptively Nonmedical"

• "Special Exception Items"

• "Necessary and Reasonable"

• "Necessity for the Equipment"

• "Reasonableness of the Equipment"

• "Payment Consistent With What is Necessary and Reasonable"

• "Beneficiary's Home"

• "Establishing the Period of Medical Necessity"

• "Repairs, Maintenance, Replacement and Delivery"

• "Leased Renal Dialysis Equipment"

• "Coverage of Supplies and Accessories"

• "Beneficiary Disposal of Equipment"

• "New Supplier Effective Billing Date"

• "Incurred Expense Date"

• "Partial Months-Monthly Payment"

• "Purchased Equipment Delivered Outside the U.S."

1 comment:

  1. In durable medical equipment, there is a important role of pharmacy robots. these robots are used in automated medication dispensing.

    ReplyDelete

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