Article Detail - JA DME

All items billed to Medicare require a standard written order (SWO), and the beneficiary’s medical record needs to substantiate that order. Beneficiaries need to see their practitioner so that medical need can be established and so the practitioner can order the specific DMEPOS item needed.

The Required Face-to-Face Encounter and Written Order Prior to Delivery (WOPD) List is a list of DMEPOS items which require the beneficiary to see their practitioner within six months preceding the order, and have a WOPD on file with the supplier within six months of the face-to-face encounter.

The absence of a DMEPOS item from the Required List does not mean that the beneficiary has no need of a practitioner encounter; it just means that the beneficiary does not have to follow the face-to-face and WOPD timeline requirements. All policies require a practitioner encounter confirming medical necessity for item(s) ordered, and suppliers should be sure to follow individual policy guidelines. The only difference between items that require a face-to-face and WOPD and those that do not is the completion timeline for the physician encounter and order.