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Looking for certified products & systems? We certify millions of products This mark is your assurance that the product has been tested by one of the most respected independent certification organizations in existence today. It is valued by consumers, manufacturers, retailers and regulatory agencies worldwide.TITLE: DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS AND SUPPLIES (DMEPOS) AUTHORITY:  38 CFR 17.270(a), 17.272(a), 17.273(e), and 17.274(a) RELATED AUTHORITY:  32 CFR 199.2 and 32 CFR 199.4(d)(3)(ii) HCPCS Level II Codes: E0100-E0172, E0181-E0189, E0191-E0199, E0202, E0217, E0235, E0247-E0272, E0275-E0310, E0316-E0445, E0450-E0480, E0482-E0601, E0604, E0606-E0619, E0621-E0625, E0636, E0639-E0640, E0650-E0694, E0705-E0749, E0756-E0764, E0769-E0942, E0944-E0948, E0951-E1298, E1353-E1406, E1510-E1800, E1802, E1805, E1810, E1812, E1820, E1825-E1840, E2000-E2101, K0001-K0462, and K0739-K0740 A.      Durable Medical Equipment (DME) is equipment that:

1.       Is medically necessary for the treatment of a covered illness or injury. 2.       Improves the function of a malformed, diseased, or injured body part, or delays further deterioration of a patient’s physical condition. 3.       Is primarily and customarily used to serve a medical purpose, rather than primarily for transportation, comfort or convenience. 4.       Provides the medically appropriate level of performance and quality for the medical condition present, that is, non-luxury and non-deluxe. A.      DME that is ordered as a medical necessity by a physician for the specific use of the beneficiary, and that complies with the applicable conditions, exceptions, limitations and exclusions of this manual is covered: 1.       Preauthorization is required for any item purchased or rented with a total purchase price that exceeds $2,000. B.      The attending physician must prescribe equipment for a use consistent with required Food and Drug Administration (FDA) approved labeling for the item.  

When prescribed use of an item appears to be extraordinary, a signed statement from the manufacturer that a specific medical device is FDA approved for such use is adequate evidence that the CHAMPVA requirement of FDA approval is met. C.      Repair of beneficiary owned DME, which otherwise meets the DME benefit requirement, is covered when necessary to make the equipment serviceable: 1.       The repair charge may include the use of a temporary replacement item provided during the period of repair. D.      Replacement of beneficiary owned DME, which otherwise meets the DME benefit requirement, is covered when the item is not serviceable due to normal wear, accidental damage, a change in the beneficiary's condition, or the device has been declared adulterated by the FDA. For life-support equipment, a new item may be purchased when the same type of item in use is within 90 days of the manufacturer’s recommended replacement threshold. E.       A wheelchair, or an approved alternative, which is necessary to provide basic mobility is covered:

1.       Medically necessary modifications may be covered. 2.       A vehicle lift for a wheelchair, or an approved alternative, is considered an accessory and labor costs for installation may be covered. F.       Customization, accessories and supplies that are essential for beneficiary owned DME, which otherwise meets the DME requirements to provide therapeutic benefit, or to assure the proper functioning of the equipment, or to make the equipment serviceable is covered. G.      A duplicate item of DME, which otherwise meets the DME benefit requirement that is essential to provide a fail safe, in home, life support system, is covered. A.      DME for a beneficiary who is a patient in a type of facility that ordinarily provides the same type of items to its patients at no additional charge in the usual course of providing its services. B.      DME for which a beneficiary has no obligation to pay (DME received at no charge from a Uniformed Services Medical Treatment Facility).

C.      DME with deluxe, luxury or immaterial features that increase the cost of the item to the government relative to a similar item without those features. E.       Routine periodic servicing, such as testing, cleaning, regulating, and checking which the manufacturer does not require to be performed by an authorized technician. F.       Rental or purchase of an allowed item, other than life-support equipment, solely to be used as a back-up to currently owned or rented equipment: 1.       A cost that is non advantageous to the government shall not be allowed, even when the equipment cannot be rented or purchased within a "reasonable distance" of the beneficiary's current address.  The charge for delivery and pick up is an allowable part of the cost of an item; consequently, distance does not limit access to equipment. 2.       Line item interest and carrying charges for equipment purchase shall not be allowed.  CHAMPVA lump sum payment for purchase of an item of equipment is the limit of the government cost-share liability.  

Interest and carrying charges result from an arrangement between the beneficiary and the equipment vendor for prorated payment of the beneficiary's cost-share liability over time. G.      Vehicle lifts that are non-detachable, and/or manufactured for a specific vehicle that cannot be removed from one vehicle and used in another vehicle, are viewed as customizations to the vehicle and not an accessory to the wheelchair, and are not covered. I.        Household chairs, with or without lift mechanism. J.        Recliner chairs, with or without lift mechanism. K.      Spectacles, eyeglasses, contact lenses or other optical devices.Exercise equipment, spas, whirlpools, hot tubs, swimming pools. N.      Communication devices except those Augmentative Communication Devices (ACDs), also referred to as Speech Generating Devices (SGDs), that provide an individual who has a severe speech impairment with the ability to meet functional speaking needs when appropriate based on benefit policy.