Medicaid DME billing guidelines

DME Policy

The DME program covers medically necessary durable medical equipment, prosthetics, orthotics, and disposable medical supplies (DMEPOS); which includes oxygen and related supplies, parenteral and enteral nutrition and medical foods. Medicaid Services Manual (MSM) Chapter 1300 contains Nevada Medicaid DME policy, including but not limited to: documentation requirements, dispensing and
delivery of items, recipient qualifications, coverage and limitations.

Durable Medical Equipment (DME) is medical equipment that:

• Can withstand repeated use;
• Is primarily and customarily used to serve a medical purpose;
• Is generally not useful to a person in the absence of illness or injury; and

• Is appropriate for use in the home.

Products and services must be medically necessary, safe and appropriate for the course and
severity of the condition using the least costly and equally effective alternative to meet the recipient’s
needs.

Remember to check http://nevada.fhsc.com at least weekly for updates, policy changes, and Web Announcements!

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