For repairs to equipment not purchased by Medicare, what are the requirements?
CMS policy is clear. IOM 100-2, Ch. 15, ยง110.2 states, “[P]ayment may be made for repair, maintenance, and replacement of medically required DME, including equipment which had been in use before the user enrolled in Part B of the program.” Key to implementing this provision is in understanding the criteria that the equipment is “medically required DME”. The criteria means that all of the applicable benefit category and reasonable and necessary requirements for the base item must be met before the item is eligible to have repairs reimbursed. These criteria are generally found in the relevant LCD.
