Standard Written Order (SWO)

Effective with dates of service on or after January 1, 2020 a Standard Written Order (SWO) must be communicated to a supplier before billing for any item of DMEPOS.

Someone other than the treating practitioner may complete the SWO of the item unless statute, manual instructions, the contractor's LCD or policy articles specify otherwise. However, the treating practitioner must review the content and sign the document.

For certain items of DMEPOS, a written order is required prior to delivery (WOPD) of the item(s) to the beneficiary (see below).

A SWO must contain all the following elements:

  • Beneficiary's name or Medicare Beneficiary Identifier (MBI)
  • Order Date
  • General description of the item
    • The description can be either a general description (e.g., wheelchair or hospital bed), a HCPCS code, a HCPCS code narrative, or a brand name/model number
    • For equipment - In addition to the description of the base item, the SWO may include all concurrently ordered options, accessories or additional features that are separately billed or require an upgraded code (List each separately).
    • For supplies - In addition to the description of the base item, the DMEPOS order/prescription may include all concurrently ordered supplies that are separately billed (List each separately)
  • Quantity to be dispensed, if applicable
  • Treating Practitioner Name or National Provider Identifier (NPI)
  • Treating practitioner's signature

Upon request by a contractor, DMEPOS suppliers must provide documentation of the completed SWO.

In those limited instances in which the treating practitioner is also the supplier and is permitted to furnish specific items of DMEPOS and fulfill the role of the supplier in accordance with any applicable laws and policies, a SWO is not required.  However, the medical record must still contain all of the required SWO elements.

Written Orders Prior to Delivery (WOPD)

A WOPD is a completed SWO that is communicated to the DMEPOS supplier before delivery of the item(s).

Pursuant to Final Rule 1713 (84 Fed. Reg Vol 217), CMS may select DMEPOS items appearing on the Master List of DMEPOS Items potentially subject to a Face-to-Face Encounter and Written Order Prior to Delivery requirement and include them on a Required List.

The Required List will be comprised of:

  • Statutorily required DMEPOS items such as Power Mobility Devices (PMDs); and
  • Additional DMEPOS items selected by CMS appearing on the Required List.

Items appearing on the Required List are subject to the face-to-face encounter and written order prior to delivery requirements. Please refer to the Standard Documentation Requirements Article (A55426) for additional information.

CMS and the DME MACs will post on their websites the Required List of the selected HCPCS codes, once published through the Federal Register Notice, and the Required List will be periodically updated.


Signatures must comply with the CMS signature requirements outlined in CMS Internet-Only Manuals 100-08, Program Integrity Manual (PIM), Chapter 3, Section Signature and date stamps are not allowed.

A prescription is not considered as part of the medical record. Medical information intended to demonstrate compliance with coverage criteria may be included on the prescription but must be corroborated by information contained in the medical record.

Last Updated May 10 , 2024