Medicaid Benefits: Online Database

Customize Your Search

Show year(s):

Switch to another service...

Category...

Service...

Benefits by Service: Medical Equipment and Supplies (October 2008) Definition/Notes

Note: Totals include 50 states and D.C.

"Benefits Covered" Totals

"Benefits Not Covered" Totals

Is the benefit covered?

Is there a co-payment requirement?

Yes: 15

No: 36

Is the Benefit Covered?	Copayment Requirement	Prior Approval Requirement	Coverage Limitations	Reimbursement Methodology	Populations Covered

Alabama
Yes	$1-$3/ service or item, depending on payment			Fee for service using Medicare payment ceilings, some items paid cost plus percentage	CN
Alaska
Yes		Specified med equipment and med supply items		Fee for service	CN
Arizona
Yes		Specified med equipment and med supply items, depending on cost	1 med equipment purchase of the same type/2 years	Fee for service using Medicare payment ceilings	CN & MN
Arkansas
Yes		Specified med equipment and med supply items	Med supplies limited to $250/month	Fee for service for med equipment, med supplies paid up to Medicare payment ceilings	CN & MN
California
Yes		Specified med equipment and med supply items, depending on cost		Fee for service for most products, incontinence supplies available through state's volume purchase contracts	CN & MN
Colorado
Yes	$1/date of service	Specified med equipment and med supply items		Fee for service	CN
Connecticut
Yes		Specified med equipment and med supply items		Fee for service	CN & MN
Delaware
Yes				Fee for service, using Medicare payment ceilings when available	CN
District of Columbia
Yes		Specified med equipment and med supply items, depending on cost		Fee for service	CN & MN
Florida
Yes		Specified med equipment and med supply items	Limitations vary by item	Fee for service or individually priced	CN & MN
Georgia
Yes	$3/med equipment item, $1/med supply item or rental of med equipment item per month	Specified med equipment and med supply items including enteral formula	Coverage for nursing facility residents limited to augmentative communication devices	Fee for service at 80% of CMS 2007 rates	CN & MN
Hawaii
Yes		Specified items		Fee for service	CN & MN
Idaho
Yes		Specified med equipment and med supply items,		Fee for service	CN
Illinois
Yes		Specified med equipment and med supply items		Fee for service	CN & MN
Indiana
Yes		Specified med equipment and med supply items	$1950 maximum benefit/year for incontinence products and products must be obtained from a contracted vendor	Fee for service using historical Medicare payment rates	CN
Iowa
Yes	$2/day	Specified med equipment and med supply items	Oxygen systems limited to specific medical conditions, med supplies limited to 3 month supply	Fee for service	CN & MN
Kansas
Yes	$3/service or item		Only services or items that would reduce or prevent institutionalization or necessary for school, employment or life support	Reasonable charge with limits	CN & MN
Kentucky
Yes	A, C & D - 3% of payment/per item up to $15/month		Limited to items used in the home and in accordance with restrictions contained in state regulations	Fee for service or invoice price plus 20% or suggested retail price minus 15-22%	A, B, C & D - See state-specific FN
Louisiana
Yes		Yes		Fee for service, some items individually priced	CN & MN
Maine
Yes	$.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip)	Specified services	Varying limits depending on item	Fee for service	CN & MN
Maryland
Yes		Specified med equipment and med supply items, depending on cost	Medical equipment coverage limited to one piece per need and use in home	Fee for service	CN & MN
Massachusetts
Yes		Yes		Fee for service	CN & MN
Michigan
Yes		Specified med equipment and med supply items	Limitations vary by type of equipment o supply	Fee for service for most products, incontinence supplies available through state's volume purchase contractor	CN & MN
Minnesota
Yes		Specified services		Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors	A & B - See state-specific FN
Mississippi
Yes	$.50-$3/DME service or item, depending on payment	Yes		Fee for service using a percentage of Medicare allowable cost as ceiling	CN
Missouri
Yes		Yes	Adult coverage other than for pregnant or blind limited to specified items unless provided through home health plan of care	Fee for service	CN & MN
Montana
Yes	$5/service or item	Med equipment or supply items costing more than $1,000		Fee for service or percentage of charge	A & B - See state-specific FN
Nebraska
Yes		Specified med equipment and med supply items costing more than $500		Fee for service	CN & MN
Nevada
Yes		Specified items		Fee for service	CN
New Hampshire
Yes		Disposable incontinence supplies and med equipment items		Fee for service, adjusted retail price or individual pricing	CN & MN
New Jersey
Yes		Specified med equipment and med supply items		Fee for service, some items paid invoice cost plus percentage	CN & MN
New Mexico
Yes		Specified med equipment items	Most med equipment items covered only once/3 years, specified monthly quantity limits for medical supplies, custom wheelchair requires prior PT and/or OT evaluation	Fee for service using Medicare payment ceilings	CN
New York
Yes	$1/order	Specified med equipment and med supply items		Fee for service, some items paid invoice cost plus percentage	CN & MN
North Carolina
Yes		Specified items and services including repairs	Lifetime expectancy limitations applied to specified items	Fee for service based on Medicare rates or reasonable cost	CN & MN
North Dakota
Yes		Med equipment or med supply items costing more than $500		Fee for service	CN & MN
Ohio
Yes		Specified med equipment and supply items, certain specified repairs costing more than $100		Fee for service, some items paid percentage of item's list price	CN
Oklahoma
Yes				Fee for service	CN
Oregon
Yes		Specified med equipment and med supply items	B - limited to specified diabetic, ostomy and respiratory med equipment and supplies	Fee for service	A & B - See state-specific FN
Pennsylvania
Yes	$.50-$3/service, depending on payment rate for purchased items only, not applicable to oxygen	For equipment other than oxygen	MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care	Fee for service	CN & MN
Rhode Island
Yes		Yes	Coverage of molded shoes varies by group	Fee for service or reasonable charge with ceilings	CN & MN - see state-specific FN
South Carolina
Yes	$3/provider/day			Fee for service using a percentage of Medicare payment rates as a ceiling	CN
South Dakota
Yes	5% of payment for med equipment item, $1/med supply item, $2/day enteral supply, $5/day parenteral supply			Fee for service, some items paid percentage of charge	CN
Tennessee
Yes					A & B - See state-specific FN
Texas
Yes		Specified items		Fee for service	CN & MN
Utah
Yes	C - 10% of payment for item	Specified med equipment and med supply items	B & C - limited list of covered equipment and supplies	Fee for service, wheelchairs paid discounted price plus design fee, augmentative communication devices paid percentage of list price with limits	A, B & C - See state-specific FN
Vermont
Yes		Specified med equipment and med supply items	B - only covered under PC Plus	Fee for service	A & B - See state-specific FN
Virginia
Yes		Specified items	Limits vary by item	Fee for service, home infusion therapy paid per diem	CN & MN
Washington
Yes		Specified med equipment and med supply items	Quantity and frequency limits vary by item	Fee for service	CN & MN
West Virginia
Yes		Yes	A - $1,000/year	Fee for service	A & B
Wisconsin
Yes	$.50-$3, depending on service or item	Specified med equipment and med supply items, depending on cost	Limited items available to nursing facility residents	Fee for service for med equipment, med supplies paid cost plus mark-up	CN & MN
Wyoming
Yes		Specified items and services		Fee for service, some items paid acquisition cost plus 15% shipping and handling charge	CN
American Samoa
Yes					See territory-specific FN
Guam
Yes				Fee for service	CN
Northern Mariana Islands
Yes		Yes	1 wheelchair/5 years, non-motorized only		CN & MN - See territory-specific FN
Puerto Rico
No
Virgin Islands
No

Definition/Notes: Link to Medical Equipment and Supplies Footnote


Switch to another service...
Category...
Service...