3.2 Durable Medical Equipment

(Procedure code 15701-01, 15702-01, 15706-01)

Durable medical equipment is equipment which can withstand repeated use, and which generally does not have a value to the patient in the absence of an illness or injury. Durable medical equipment can be purchased or rented. Purchase of durable medical equipment, other than wheelchairs, will be paid at 80% of the usual and customary rate. In the rare instances that a hospital furnishes durable medical equipment to an individual for home-use, the use of such equipment is considered part of the allowable hospital fee and does not warrant separate payment.

NOTE: See the DVR Service Delivery Policy Manual on vendor selection for the purchase of wheelchairs and other adaptive equipment that must be customized to meet the individual’s specific needs. Customized adaptive equipment does not require the use of the formalized bid process.

When the need for medical equipment is temporary, such equipment shall be rented rather than purchased when it is the least possible cost option. Repair of durable medical equipment shall be made at the lowest usual and customary rate when it is cost-effective to do so.