Medical Policies Durable Equipment
Ambulatory Devices Commercial - Durable Medical Equipment 40
PDF, 221 KB
PDF, 221 KB
Ambulatory Devices Medicaid - Durable Medical Equipment 40
PDF, 273 KB
PDF, 273 KB
Augmentative Communication and Speech Generating Systems Commercial - Durable Medical Equipment 30
PDF, 230 KB
PDF, 230 KB
Augmentative Communication and Speech Generating Systems Medicaid- Durable Medical Equipment 30
PDF, 274 KB
PDF, 274 KB
Automated External Defibrillators (AED) Commercial - Durable Medical Equipment 63
PDF, 252 KB
PDF, 252 KB
Automated External Defibrillators (AED) Medicaid - Durable Medical Equipment 63
PDF, 304 KB
PDF, 304 KB
Compression Stockings and Garments Commercial - Durable Medical Equipment 04
PDF, 219 KB
PDF, 219 KB
Compression Stockings and Garments Medicaid - Durable Medical Equipment 04
PDF, 272 KB
PDF, 272 KB
Continuous Glucose Monitoring Systems Commercial - Durable Medical Equipment 10
PDF, 218 KB
PDF, 218 KB
Continuous Glucose Monitoring Systems Medicaid - Durable Medical Equipment 10
PDF, 321 KB
PDF, 321 KB
Continuous Passive Motion Commercial - Durable Medical Equipment 27
PDF, 220 KB
PDF, 220 KB
Continuous Passive Motion Medicaid - Durable Medical Equipment 27
PDF, 268 KB
PDF, 268 KB
Cranial Electrotherapy Stimulation Commercial - Durable Medical Equipment
PDF, 200 KB
PDF, 200 KB
Cranial Electrotherapy Stimulation Medicaid - Durable Medical Equipment 59
PDF, 246 KB
PDF, 246 KB
Cranial Electrotherapy Stimulation Medicare - Durable Medical Equipment 59
PDF, 245 KB
PDF, 245 KB
Diabetic Shoes Commercial - Durable Medical Equipment 20
PDF, 221 KB
PDF, 221 KB
Diabetic Shoes Medicaid - Durable Medical Equipment 20
PDF, 272 KB
PDF, 272 KB
Diapers and Underpads Commercial - Durable Medical Equipment 246
PDF, 197 KB
PDF, 197 KB
Diapers and Underpads Medicaid - Durable Medical Equipment 246
PDF, 277 KB
PDF, 277 KB
Electric and Electromagnetic and Ultrasonic Bone Growth Stimulation Commercial - Durable Medical Equipment 09
PDF, 224 KB
PDF, 224 KB
Electric and Electromagnetic and Ultrasonic Bone Growth Stimulation Medicaid - Durable Medical Equipment 09
PDF, 269 KB
PDF, 269 KB
Electric Stimulation Commercial - Durable Medical Equipment 07
PDF, 240 KB
PDF, 240 KB
Electric Stimulation Medicaid - Durable Medical Equipment 07
PDF, 290 KB
PDF, 290 KB
Electrical Stimulation and Electromagnetic Therapy for Wounds Commercial - Durable Medical Equipment 01
PDF, 215 KB
PDF, 215 KB
Electrical Stimulation and Electromagnetic Therapy for Wounds Medicaid - Durable Medical Equipment 01
PDF, 276 KB
PDF, 276 KB
External Insulin Infusion Pump Commercial - Durable Medical Equipment 11
PDF, 219 KB
PDF, 219 KB
External Insulin Infusion Pump Medicaid - Durable Medical Equipment 11
PDF, 301 KB
PDF, 301 KB
Foot Orthotics Commercial - Durable Medical Equipment 64
PDF, 247 KB
PDF, 247 KB
Foot Orthotics Medicaid - Durable Medical Equipment 64
PDF, 298 KB
PDF, 298 KB
High Frequency Chest Wall Compression Commercial - Durable Medical Equipment 14
PDF, 212 KB
PDF, 212 KB
High Frequency Chest Wall Compression Medicaid - Durable Medical Equipment 14
PDF, 269 KB
PDF, 269 KB
Home Spirometry Commercial - Durable Medical Equipment 23
PDF, 189 KB
PDF, 189 KB
Home Spirometry Medicaid - Durable Medical Equipment 23
PDF, 245 KB
PDF, 245 KB
Home Traction Devices Commercial - Durable Medical Equipment 35
PDF, 211 KB
PDF, 211 KB
Home Traction Devices Medicaid - Durable Medical Equipment 35
PDF, 256 KB
PDF, 256 KB
Home Visual Field Monitoring Device Commercial - Durable Medical Equipment 62
PDF, 192 KB
PDF, 192 KB
Home Visual Field Monitoring Device Medicaid - Durable Medical Equipment 62
PDF, 248 KB
PDF, 248 KB
Home Visual Field Monitoring Device Medicare - Durable Medical Equipment 62
PDF, 243 KB
PDF, 243 KB
Hospital Beds and Accessories Commercial - Durable Medical Equipment 03
PDF, 239 KB
PDF, 239 KB
Hospital Beds and Accessories Medicaid - Durable Medical Equipment 03
PDF, 306 KB
PDF, 306 KB
Infant Home Apnea Monitor Commercial - Durable Medical Equipment 22
PDF, 214 KB
PDF, 214 KB
Infant Home Apnea Monitor Medicaid - Durable Medical Equipment 22
PDF, 322 KB
PDF, 322 KB
Intra-Oral Appliances and Splints for Temporomandibular Joint (TMJ) Syndrome Commercial - Durable Medical Equipment 222
PDF, 213 KB
PDF, 213 KB
Intra-Oral Appliances and Splints for Temporomandibular Joint (TMJ) Syndrome Medicaid - Durable Medical Equipment 222
PDF, 263 KB
PDF, 263 KB
Intra-Oral Appliances and Splints for Temporomandibular Joint (TMJ) Syndrome Medicare - Durable Medical Equipment 222
PDF, 248 KB
PDF, 248 KB
Iontophoresis Treatment for Hyperhidrosis Commercial - Durable Medical Equipment 32
PDF, 209 KB
PDF, 209 KB
Iontophoresis Treatment for Hyperhidrosis Medicaid - Durable Medical Equipment 32
PDF, 259 KB
PDF, 259 KB
Iontophoresis Treatment for Hyperhidrosis Medicare - Durable Medical Equipment 32
PDF, 247 KB
PDF, 247 KB
Jaw Motion Rehabilitation Systems Commercial - Durable Medical Equipment 43
PDF, 196 KB
PDF, 196 KB
Jaw Motion Rehabilitation Systems Medicaid - Durable Medical Equipment 43
PDF, 249 KB
PDF, 249 KB
Jaw Motion Rehabilitation Systems Medicare - Durable Medical Equipment 43
PDF, 233 KB
PDF, 233 KB
Low-Intensity Therapeutic Ultrasound (LITUS) Devices Commercial - Durable Medical Equipment 55
PDF, 236 KB
PDF, 236 KB
Low-Intensity Therapeutic Ultrasound (LITUS) Devices Medicaid - Durable Medical Equipment 55
PDF, 277 KB
PDF, 277 KB
Low-Intensity Therapeutic Ultrasound (LITUS) Devices Medicare - Durable Medical Equipment 55
PDF, 232 KB
PDF, 232 KB
Lymphedema Pump for Head and Neck Commercial - Durable Medical Equipment 245
PDF, 196 KB
PDF, 196 KB
Lymphedema Pump for Head and Neck Medicaid - Durable Medical Equipment 245
PDF, 240 KB
PDF, 240 KB
Mastectomy Garments Commercial - Durable Medical Equipment 240
PDF, 204 KB
PDF, 204 KB
Mastectomy Garments Medicaid - Durable Medical Equipment 240
PDF, 256 KB
PDF, 256 KB
Medical Car Seats Commercial - Durable Medical Equipment 58
PDF, 192 KB
PDF, 192 KB
Medical Car Seats Medicaid - Durable Medical Equipment 58
PDF, 256 KB
PDF, 256 KB
Medical Car Seats Medicare - Durable Medical Equipment 58
PDF, 224 KB
PDF, 224 KB
Miscellaneous Assistive Devices for Home Use Commercial - Durable Medical Equipment 34
PDF, 207 KB
PDF, 207 KB
Miscellaneous Assistive Devices for Home Use Medicaid - Durable Medical Equipment 34
PDF, 280 KB
PDF, 280 KB
Needleless Injection Commercial - Durable Medical Equipment 26
PDF, 248 KB
PDF, 248 KB
Needleless Injection Medicaid - Durable Medical Equipment 26
PDF, 300 KB
PDF, 300 KB
Neuromuscular Electrical Stimulator and Functional Electrical Stimulators Commercial - Durable Medical Equipment 17
PDF, 224 KB
PDF, 224 KB
Neuromuscular Electrical Stimulator and Functional Electrical Stimulators Medicaid - Durable Medical Equipment 17
PDF, 267 KB
PDF, 267 KB
Non-Surgical Eyelid Weights Commercial - Durable Medical Equipment 61
PDF, 192 KB
PDF, 192 KB
Non-Surgical Eyelid Weights Medicaid - Durable Medical Equipment 61
PDF, 243 KB
PDF, 243 KB
Non-Surgical Eyelid Weights Medicare - Durable Medical Equipment 61
PDF, 230 KB
PDF, 230 KB
Obstructive Sleep Apnea Oral Devices Commercial - Durable Medical Equipment 250
PDF, 188 KB
PDF, 188 KB
Obstructive Sleep Apnea Oral Devices Medicaid - Durable Medical Equipment 250
PDF, 274 KB
PDF, 274 KB
Obstructive Sleep Apnea Oral Devices Medicare - Durable Medical Equipment 250
PDF, 271 KB
PDF, 271 KB
Oxygen for Home Use Commercial - Durable Medical Equipment 29
PDF, 244 KB
PDF, 244 KB
Oxygen for Home Use Medicaid - Durable Medical Equipment 29
PDF, 468 KB
PDF, 468 KB
Pads with Circulating Liquid for Pain Relief Commercial - Durable Medical Equipment 242
PDF, 190 KB
PDF, 190 KB
Pads with Circulating Liquid for Pain Relief Medicaid - Durable Medical Equipment 242
PDF, 241 KB
PDF, 241 KB
Pneumatic Compression of the Chest or Trunk Commercial - Durable Medical Equipment 53
PDF, 196 KB
PDF, 196 KB
Pneumatic Compression of the Chest or Trunk Medicaid - Durable Medical Equipment 53
PDF, 242 KB
PDF, 242 KB
Postural Support Seat Commercial - Durable Medical Equipment 56
PDF, 195 KB
PDF, 195 KB
Postural Support Seat Medicaid - Durable Medical Equipment 56
PDF, 256 KB
PDF, 256 KB
Postural Support Seat Medicare - Durable Medical Equipment 56
PDF, 228 KB
PDF, 228 KB
Prosthetic Devices Commercial - Durable Medical Equipment 21
PDF, 308 KB
PDF, 308 KB
Prosthetic Devices Medicaid - Durable Medical Equipment 21
PDF, 353 KB
PDF, 353 KB
Scalp Cooling During Chemotherapy Commercial - Durable Medical Equipment 249
PDF, 201 KB
PDF, 201 KB
Scalp Cooling During Chemotherapy Medicaid - Durable Medical Equipment 249
PDF, 251 KB
PDF, 251 KB
Second Ventilator Commercial - Durable Medical Equipment 51
PDF, 196 KB
PDF, 196 KB
Second Ventilator Medicaid - Durable Medical Equipment 51
PDF, 247 KB
PDF, 247 KB
Single Use Negative Pressure Wound Therapy System Commercial - Durable Medical Equipment 241
PDF, 201 KB
PDF, 201 KB
Single Use Negative Pressure Wound Therapy System Medicaid - Durable Medical Equipment 241
PDF, 254 KB
PDF, 254 KB
Spinal Braces, Orthotics and Garments Commercial - Durable Medical Equipment 244
PDF, 243 KB
PDF, 243 KB
Spinal Braces, Orthotics and Garments Medicaid - Durable Medical Equipment 244
PDF, 294 KB
PDF, 294 KB
Standing Frames Commercial - Durable Medical Equipment 41
PDF, 210 KB
PDF, 210 KB
Standing Frames Medicaid - Durable Medical Equipment 41
PDF, 289 KB
PDF, 289 KB
Static and Dynamic Mechanical Stretching Devices Commercial - Durable Medical Equipment 31
PDF, 263 KB
PDF, 263 KB
Static and Dynamic Mechanical Stretching Devices Medicaid - Durable Medical Equipment 31
PDF, 314 KB
PDF, 314 KB
Static and Dynamic Mechanical Stretching Devices Medicare - Durable Medical Equipment 31
PDF, 299 KB
PDF, 299 KB
Transfer Devices and Lifts Commercial - Durable Medical Equipment 42
PDF, 226 KB
PDF, 226 KB
Transfer Devices and Lifts Medicaid - Durable Medical Equipment 42
PDF, 257 KB
PDF, 257 KB
Ultraviolet Light Therapy System for Home Use Commercial - Durable Medical Equipment 60
PDF, 216 KB
PDF, 216 KB
Ultraviolet Light Therapy System for Home Use Medicaid - Durable Medical Equipment 60
PDF, 267 KB
PDF, 267 KB
Vertigo, Tinnitus, and Meniere’s Diagnosis Treatment Devices Commercial - Durable Medical Equipment 225
PDF, 230 KB
PDF, 230 KB
Vertigo, Tinnitus, and Meniere’s Diagnosis Treatment Devices Medicaid - Durable Medical Equipment 225
PDF, 285 KB
PDF, 285 KB
Vertigo, Tinnitus, and Meniere’s Diagnosis Treatment Devices Medicare - Durable Medical Equipment 225
PDF, 265 KB
PDF, 265 KB
Vitrectomy Face-Down Positioning System Commercial - Durable Medical Equipment 33
PDF, 193 KB
PDF, 193 KB
Vitrectomy Face-Down Positioning System Medicaid - Durable Medical Equipment 33
PDF, 244 KB
PDF, 244 KB
Vitrectomy Face-Down Positioning System Medicare - Durable Medical Equipment 33
PDF, 231 KB
PDF, 231 KB
Wearable External Cardioverter Defibrillators Commercial - Durable Medical Equipment 24
PDF, 246 KB
PDF, 246 KB
Wearable External Cardioverter Defibrillators Medicaid - Durable Medical Equipment 24
PDF, 291 KB
PDF, 291 KB
Wheelchairs, Power Motorized Devices, Motorized Scooters and Accessories Commercial - Durable Medical Equipment 28
PDF, 357 KB
PDF, 357 KB
Wheelchairs, Power Motorized Devices, Motorized Scooters and Accessories Medicaid - Durable Medical Equipment 28
PDF, 386 KB
PDF, 386 KB