What is a Certificate of Medical Necessity (CMN)?
A Certificate of Medical Necessity (CMN) is a form required by Medicare authorizing the use of certain durable medical items and equipment prescribed by a physician. This form is to be completed by your doctor or the doctor’s agent. Your supplier will coordinate with your doctor to see that all the necessary information is submitted to Medicare. A change in prescription and/or a change in the beneficiary’s condition will require that an updated certificate be completed and submitted. Note: The CMN must be completed and returned to the supplier prior to the beneficiary receiving the item. A completed CMN does not guarantee that Medicare will cover the item as medical necessity is determined by the prescriber’s responses to the questions on the CMN. What supplies require a certificate of medical necessity (CMN)? Condo Pharmacy sells the following items requiring a CMN: 1. Seat lift mechanisms (Lift chairs) 2. Transcutaneous electronic nerve stimulators (TENS Units) What is a “capped rent
Most health insurance programs will cover some or all of the cost of necessary durable medical equipment. Because this equipment is expensive, and it is often needed for months, if not years, insurance companies want to be sure that this medical equipment is really necessary. It’s not unheard of for patients or their families to want certain equipment more for convenience than because they truly need it to treat or manage a medical need. Insurance companies hate that. . . .
In early 1999, the Health Care Financing Administration (HCFA) began requiring that a CMN be completed for any patient covered by Medicare for non-emergency ambulance transports. This does not apply to patients who are not covered by Medicare. All ambulance services are required to submit these forms. . The form, signed by a physician, nurse practitioner, or clinical nurse specialist, attests that ambulance transport was necessary due to certain medical criteria or conditions. . Please call our Communications Center at 800.476.5433 with your other questions regarding CMN’s.
Related Questions
- In a post-payment audit, is an original physicians signature still required on the Certificate of Medical Necessity (CMN) or will a faxed CMN be accepted?
- How does a supplier handle an electronically transmitted Certificate of Medical Necessity (CMN) rejection?
- What supplies require a certificate of medical necessity (CMN)?
