Durable Medical Equipment (DME)
Durable medical equipment (DME) is reusable equipment that serves a medical purpose and is appropriate for use in the home, such as walkers, wheelchairs, hospital beds, oxygen equipment, and infusion pumps. Medicare covers DME under Part B when a practitioner orders it, and home health clinicians are often the ones who identify the need and coordinate delivery.
How Medicare pays for DME
DME is a Part B benefit billed by an enrolled supplier, not by the home health agency. After the Part B deductible, the patient owes 20% coinsurance, and items are furnished as rentals or purchases depending on the category. Critically for home health billers, DME is excluded from home health consolidated billing: the supplier bills Medicare directly even while the patient is under a home health plan of care, unlike non-routine medical supplies, which are bundled into the PDGM payment. Coverage requires a practitioner's order, documentation of medical necessity, and for certain items additional requirements such as a face-to-face encounter handled on the prescriber side.
Common DME in home health episodes
The equipment that appears most often in home health:
- Walkers, canes, and other ambulation aids
- Standard and specialty wheelchairs
- Hospital beds, trapeze bars, and patient lifts
- Oxygen equipment and supplies
- Pressure-reducing support surfaces for wound prevention and healing
- Infusion and enteral pumps
Note what is generally not covered: bathroom safety items such as shower chairs and grab bars are usually considered non-medical convenience items under original Medicare, though some Medicare Advantage plans offer them as supplemental benefits.
The agency's role in the DME loop
Home health clinicians close the gap between need and delivery. Therapists and nurses identify the need during assessment, recommend the specific item, and communicate with the ordering practitioner to generate the order. From there the agency coordinates with the supplier on delivery timing, confirms the equipment actually arrived and fits the patient and the home, and teaches safe use. Teaching is a skilled, documentable service: a walker delivered but used incorrectly is a fall risk with a receipt. Document the recommendation, the order, the delivery, and the training, including caregiver instruction.
Common pitfalls
The most dangerous failure is timing: the patient falls in week one while the walker arrives in week three. Flag equipment needs at the first visit and follow up until delivery is confirmed. Other recurring problems include assuming the home health claim covers equipment, which confuses patients and delays orders; recommending non-covered items without telling the patient they will pay out of pocket; oxygen in use without a current order in the record; and no documented training on lifts or beds, which becomes a liability issue the day a caregiver is injured using one.
Frequently asked questions
Is DME included in the home health payment?
No. DME is excluded from home health consolidated billing and is billed to Part B by the supplier, even while the patient is on service. Non-routine medical supplies, by contrast, are bundled into the home health payment.
Does Medicare cover shower chairs or grab bars?
Generally no under original Medicare, because they are considered convenience or safety items rather than primarily medical equipment. Patients pay out of pocket, though some Medicare Advantage plans include bathroom safety equipment as a supplemental benefit. Tell patients before they order.
Who orders DME for a home health patient?
The treating practitioner writes the order, and the supplier bills Medicare. The agency's job is identification and coordination: recommending the item, prompting the order, confirming delivery, and teaching safe use, all of which should appear in the clinical record.