qualifying checklists

CPAP and BiPAP Therapy

Positive Airway Pressure (PAP) Devices for the treatment of OSA with a qualifying facility based sleep test.

Enteral Nutrition

 Enteral nutrition administered by syringe, gravity, or pump.  

Group 1 & 2 Support Surfaces

  A pressure reducing support surface is designed to prevent or promote the healing of certain types of pressure ulcers by reducing or eliminating tissue interface pressure. 

Hospital Beds and Accessories

A semi electric hospital bed is covered if the beneficiary requires frequent changes in body position and/or has an immediate need for a change in body position.

Manual Wheelchairs

Wheelchairs for use inside the home for beneficiaries that have mobility limitation that significantly impairs  his/her ability to participate in one or more mobility-related activities of daily living (MRADLs) such as toileting, feeding, dressing, grooming, and bathing in customary locations in the home 

Oxygen Therapy

 Home oxygen is covered only when both the reasonable and necessary criteria and the statutory criteria  are met.