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DMEPOS Payment Categories

Category Brief Description
Capped Rental Items Items in this category are paid on a monthly rental basis not to exceed a period of continuous use of 13 months.
Customized Items Coverage and allowable amounts for custom equipment will be decided by individual evaluation based on medical indication.
Inexpensive and Routinely Purchased (IRP)

Inexpensive DME
This category is defined as equipment whose purchase price does not exceed $150.

Other Routinely Purchased DME
This category consists of equipment that is purchased at least 75 percent of the time.
Items Requiring Frequent and Substantial Servicing

Equipment in this category is paid on a rental basis only. Payment is based on the monthly fee schedule amounts until medical necessity ends. No payment is made for the purchase of equipment, maintenance and servicing, or for replacement of items in this category.

Supplies and accessories are not allowed separately.
Other Prosthetic and Orthotic Devices Other than a few exceptions, prosthetic and orthotic devices are paid on a lump-sum purchase basis.
Oxygen and Oxygen Equipment Payment for oxygen and oxygen equipment is paid for 36 months.
Parenteral/Enteral Nutrition (PEN) Therapy Parenteral/enteral pumps can be either rented or purchased.

 

Last Updated Apr 13, 2017