Article Detail - JD DME

The refill section of the Standard Documentation Requirements Article contains general refill requirements that pertain to all policies and was updated with a revision effective date of January 1, 2024.

Refer to CMS Medicare Learning Network (MLN) Matters (MM) 13480 - Refillable DMEPOS Documentation Requirements for update.

Individual LCDs may also have additional policy specific refill requirements.

• A routine prescription for refills is not needed.
• For items that the beneficiary obtains in-person at a retail store, the signed delivery slip or a copy of the itemized sales receipt is sufficient documentation of a request for refill.
• For items that are delivered to the beneficiary, documentation of a request for refill must be individualized to the beneficiary (i.e., the beneficiary or their caregiver/designee affirms the need for refill) and must be documented in the record. Medicare does not prescribe the mode of communication used to gather the information.
  • For example, the refill request communication may be performed via automated text messaging or email as long as each required aspect of the refill request is captured.
• A refill request must occur and be documented before shipment. A retrospective attestation statement by the supplier or beneficiary is not sufficient.

The refill record must include:

• Beneficiary’s name or name of authorized representative (if different from the beneficiary)
• A description of each item being requested
• Documentation of an affirmative response indicating a need for refill
• Date of refill request

This information must be kept on file and be available upon request.