Durable Medical Equipment

Certificate of Medical Necessity

Although your doctor’s or practitioner’s prescription is sufficient in most cases to prove that an item of DME is medically-necessary, CMS advises that for some items Medicare “requires your doctor or one of the doctor’s office staff to fill out a special form and send it to Medicare to get approval for the equipment. This is called a Certificate of Medical Necessity. Your supplier will work with your doctor to see that all required information is submitted to Medicare. If your prescription and/or condition changes, your doctor must complete and submit a new, updated certificate.”

Items requiring submission of a Certificate of Medical Necessity include:

oxygen tank

  • Bone growth stimulators
  • Home oxygen equipment and supplies
  • Lymphedema pumps or pneumatic compression devices
  • Patient lifts
  • Transcutaneous electronic nerve stimulators (TENS)

Can DME be purchased or rented from any supplier?

Medicare covers only durable medical equipment purchased or rented from a supplier enrolled in the Medicare program. In order to qualify for a Medicare supplier number, a supplier is held to strict standards, and Medicare will not pay for DME that has come from a supplier that has not been issued a Medicare supplier number. It is imperative, therefore, you ask any supplier for their Medicare supplier number before you consider renting or purchasing any item that you expect Medicare to cover. This applies whether the supplier is a small business or a large chain store. CMS advises: “To find a supplier that is enrolled in the Medicare Program, visit www.medicare.gov and select ‘Find Suppliers of Medical Equipment in Your Area.’ You can also call 1-800-MEDICARE (1-800-633-4227) to get this information. TTY users should call 1-877-486-2048.”

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