HI 00610.230 Coverage of Supplies and Accessories

Reimbursement may be made for supplies, e.g., oxygen that is necessary for the effective use of durable medical equipment (DME). Such supplies include those drugs and biologicals which must be put directly into the equipment in order to achieve the therapeutic benefit of the DME or to assure the proper functioning of the equipment, e.g., tumor chemotherapy agents used with an infusion pump or heparin used with a home dialysis system. However, the coverage of such drugs or biologicals does not preclude the need for a determination that the drug or biological itself is reasonable and necessary for treatment of the illness or injury or to improve the functioning of a malformed body member.

Reimbursement may be made for replacement of essential accessories, such as hoses, tubes, or mouth pieces for necessary DME, only if the beneficiary owns or is purchasing the equipment.