Supplier Reminder: No Coverage of Hydration Therapy Under DME Benefit

Suppliers have inquired whether hydration therapy is covered under the Durable Medical Equipment (DME) benefit provided for enteral nutrition, parenteral nutrition, and infusion therapy. Although the equipment used for nutrition and/or infusions may be covered, neither the hydration therapy itself nor the equipment and supplies for its administration are covered.

According to the CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 20, Section 10.1, DME is covered under Part B as a medical or other health service and is equipment that:

  1. Can withstand repeated use
  2. Is primarily and customarily used to serve a medical purpose
  3. Generally is not useful to a person in the absence of an illness or injury; and
  4. Is appropriate for use in the home.

All requirements of the definition must be met before an item can be considered as durable medical equipment. For any item to be covered by Medicare, it must:

  1. Be eligible for a defined Medicare benefit category,
  2. Be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and
  3. Meet all other applicable Medicare statutory and regulatory requirements.

Hydration therapy and supplies do not meet the definition of DME therefore, there is no payment for hydration therapy, or related supplies and equipment under the DME Benefit. Refer to the policy-specific LCD and Policy Article for coverage details.

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