One of the most important concepts to understand when charged with selecting a mobility device is that not all equipment is the same! There are 2 different categories of equipment that have distinct requirements and criteria: Durable Medical Equipment (DME), and Complex Rehabilitation Technology (CRT). Today we will look more closely at the more standard or basic category, DME.
DME equipment is often what people generally think of when they think of wheelchairs. These are the standard wheelchairs you see in hospitals or nursing homes and are purchased in bulk to meet short term needs. They also include scooters and standard power wheelchairs with a captain’s seat and back. DME wheelchairs are considered standard or basic as they come in limited sizes and have very little adjustability. These wheelchairs are not designed to fit individual needs but are more for short term mobility needs.
Medicare defines DME equipment by the following standards:
Used for a medical purpose
Used in the home
Able to withstand repeated use
Not usually useful to someone who is not sick, injured, or disabled
Who might be an appropriate user for DME mobility equipment?
When it comes to DME mobility equipment such as manual and power wheelchairs or power operated vehicles (POVs), the list of below can help you identify if DME is appropriate for your client.
Short-term mobility needs (e.g. temporary limitations post-surgery, fracture, or other medical condition)
Sits in the wheelchair for short periods of time (e.g. for transport pushed by someone else)
Propels only short distances
Has limited/no need for positioning support or adjustment beyond that provided by an appropriate seat cushion or back support
Does not have a postural deformity and is at minimal to no risk for developing one
Sits in "standard" dimensions without compromise
Has normal tone or minimal tonal abnormalities
Has good sitting balance
Does not have pain with sitting
Medicare requirements for DME equipment are not stringent but entail the following:
Physician order and recent exam documenting need for mobility device
No PT/OT evaluation or ATP involvement is required
Specific justification of the product may come from physician or therapist
On-site home evaluation is not required (but it is best to always conduct one if you are involved)
Does that mean that typically clients without a serious injury or condition should only need DME equipment?
Definitely not. Go back over the list of qualities that a DME wheelchair user should have. With your client in mind, if you answer "no" or "not really" to ANY of those traits, they may benefit from more advanced equipment.
The populations below (but not limited to) have traditionally been provided with standard DME equipment. This does not mean that it is actually appropriate for them.
Elderly clients
Bariatric individuals
Someone with a low activity level
Clients dependent in mobility
Always consider best clinical practice when dealing with ANY population and fight to provide what is most clinically appropriate. Many of these and other individuals might actually benefit from:
A lighter weight and optimally configured wheelchair to increase and/or allow their ability to propel and independently perform ADLs
Adjustability in their seating system to help maintain posture, prevent deformities, and decrease pain
Individualized sizing to increase function, mobility, skin protection, and sitting tolerance
An appropriate wheelchair that is configured, adjusted, and uniquely fit to them can increase independence, activity level, and quality of life for more than just the individual who is already active and independent. Also remember the 5-year rule and consider the client's prognosis to ensure you are meeting their needs over time.
Join us for our next post as we discuss the more advanced category of equipment, Complex Rehabilitation Technology (CRT). And to learn more about the fundamentals of wheeled mobility check out our guideWheeled Mobility 101.
Stacey Mullis, OTR/ATP Director of Clinical Marketing
Stacey serves as Director of Clinical Marketing for Permobil. A practicing OTR for over 20 years, she has experience in school-based pediatrics, inpatient rehabilitation, long term care, and home health. With her interest in wheelchair seating and positioning, Stacey engaged the challenges of providing appropriate seating in various clinical settings.She now uses this experience to develop programs and resources to educate clinicians on the principles of seating and wheeled mobility. She is passionate about equipping clinicians and through her previous role as Director of Clinical Education with Comfort Company and now with Permobil she has taught nationally and internationally to increase therapist capacity in this specialty area. Mullis graduated from Western University in London, Ontario, Canada with a BA Linguistics and BSc Occupational Therapy. She is a member of the NCOTA, CTF Executive Board, NRRTs, RESNA, and AOTA.
Equipment and supplies ordered by a health care provider for everyday or extended use. Coverage for DME may include: oxygen equipment, wheelchairs, crutches or blood testing strips for diabetics.
Durable medical equipment (DME) describes medical equipment and supplies ordered by a healthcare provider for a patient's routine, long-term use. DME refers to a wide variety of devices to meet all manner of medical needs, including: Nebulizers. CPAP/BiPAP machines.
Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks. Medicare usually covers DME if the equipment: Is durable, meaning it is able to withstand repeated use.
What kind of equipment does Medicare not cover? Examples: wheelchairs, walkers, hospital beds, power scooters, portable oxygen equipment, orthotics, prosthetics, certain diabetes supplies.
Durable medical equipment (DME) refers to all the hardware a person needs in order to treat their healthcare problems. Common forms of DME include walkers, neck braces, post-surgery protective eyewear, and a host of other thing. CPAP machines also belong in the category.
Monthly payments for frequently serviced items, like ventilators, are made as long as the equipment is medically necessary. You pay 20% of the Medicare-approved amount after you pay your Part B deductible for the year.Medicare pays the other 80%. The supplier will pick up the equipment when you no longer need it.
Examples of equipment that is not DME: surgical facemasks, incontinence pads, bathtub and toilet seats, wheelchair ramps, and wheelchairs or scooters that are only intended for use outside the home.
DME includes items that can be used for a long time.Medical supplies are disposable and usually used once or short term. Often these items are included in DME and may be considered DME by your insurance plan.
Distance Measuring Equipment (DME) is defined as a navigation beacon, usually coupled with a VOR beacon, to enable aircraft to measure their position relative to that beacon. Aircraft send out a signal which is sent back after a fixed delay by the DME ground equipment.
Durable medical equipment (DME), also known as DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) is equipment that primarily serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home; for example, wheelchairs, oxygen equipment, and hospital beds.
Durable medical supplies can also include disposable gloves that a patient or caregiver may wear during a daily treatment. Supplies can also include bandages, catheter equipment, needles for injection kits and diapers. If it is used once and then thrown away, it is considered a durable medical supply.
Medicare Part B defines Durable Medical Equipment as devices or items that must be used to meet a specific medical necessity, but shower chairs are not generally covered.
Durable medical supplies can also include disposable gloves that a patient or caregiver may wear during a daily treatment. Supplies can also include bandages, catheter equipment, needles for injection kits and diapers. If it is used once and then thrown away, it is considered a durable medical supply.
What is the difference between durable medical equipment and medical supplies? DME includes items that can be used for a long time.Medical supplies are disposable and usually used once or short term. Often these items are included in DME and may be considered DME by your insurance plan.
The HCPCS codes range Durable Medical Equipment E0100-E8002 is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims.
Introduction: My name is Dean Jakubowski Ret, I am a enthusiastic, friendly, homely, handsome, zealous, brainy, elegant person who loves writing and wants to share my knowledge and understanding with you.
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Stacey Mullis, OTR/ATP