Durable Medical Equipment (DME)

Document Title Document Type Document Size Effective Date
Airway Clearance Devices in the Ambulatory Setting - (0069)  PDF 169kB 03/15/2021
Ambulatory Assistance Devices - (0050)  PDF 107kB 03/15/2021
Bathroom and Toilet Equipment and Supplies - (0072)  PDF 99kB 05/15/2020
Bone Growth Stimulators: Electrical (Invasive, Noninvasive), Ultrasound - (0084)  PDF 183kB 05/15/2020
Breast Pumps - (0046)  PDF 95kB 06/15/2020
Continuous Passive Motion (CPM) Devices - (0198)  PDF 153kB 08/15/2020
Cryounits/Cooling Devices - (0314)  PDF 124kB 09/15/2020
Diabetes Equipment and Supplies - (0106)  PDF 537kB 01/15/2021
Diabetes Equipment and Supplies - (0106) ----future effective policy  PDF 551kB 07/01/2021
Electrical Stimulation Therapy and Home Devices - (0160)  PDF 767kB 09/15/2020
Hearing Aids - (0093)  PDF 289kB 06/15/2020
Home Ventilators - (0546)  PDF 166kB 10/15/2020
Hospital Beds and Accessories - (0273)  PDF 119kB 01/15/2021
Implantable Cardioverter Defibrillator (ICD) - (0181)  PDF 368kB 03/15/2020
Implantable Infusion Pump for Non-Musculoskeletal Conditions - (0370)  PDF 141kB 12/15/2020
Intraoperative Monitoring - (0509)  PDF 303kB 09/15/2020
Negative Pressure Wound Therapy/Vacuum-Assisted Closure (VAC) for Nonhealing Wounds - (0064)  PDF 225kB 05/15/2020
Orthotic Devices and Shoes - (0543)  PDF 589kB 09/15/2020
Phototherapy, Photochemotherapy, and Excimer Laser Therapy for Dermatologic Conditions - (0031)  PDF 236kB 09/15/2020
Pneumatic Compression Devices and Compression Garments - (0354)  PDF 241kB 04/15/2020
Pressure Reducing Surfaces - (0042)  PDF 149kB 02/15/2021
Seat Lift Mechanism, Patient Lifts and Standing Devices - (0343)  PDF 108kB 05/15/2020
Speech Generating Devices - (0049)  PDF 117kB 03/15/2020
Stretch Devices for Joint Stiffness and Contractures - (0135)  PDF 149kB 08/15/2020
Temporomandibular Joint (TMJ) Disorder Surgery - (0156)  PDF 122kB 12/15/2020
Vagus Nerve Stimulation (VNS) - (0350)  PDF 291kB 12/15/2020
Ventricular Assist Devices (VADs), Percutaneous Cardiac Support Systems and Total Artificial Heart - (0054)  PDF 448kB 12/15/2020
Wearable Cardioverter Defibrillator and Automatic External Defibrillator - (0431)  PDF 263kB 03/15/2020
Wheelchairs/Power Operated Vehicles - (0030)  PDF 351kB 04/15/2020