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DMEPOS Payment Categories

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) - Payment for this type of equipment is for rental or lump sum purchase. The total payment amount may not exceed the actual charge or the fee for a purchase.

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 Jun 13, 2017