Hospital Beds and Accessories - DME.HC.111.A
EVICORE-DME-5A1A5C4B
Covered: fixed-, variable‑height, semi‑electric, total‑electric, heavy‑duty (350–600 lb), extra heavy‑duty (>600 lb) hospital beds, air‑fluidized beds, and positioning cushions when specific medical indications are met; items are excluded if those documentation criteria are not satisfied (air‑fluidized beds are not indicated for pressure ulcers <stage 3). Key requirements: documented need such as body positioning not feasible with a standard bed, head‑of‑bed ≥30°, transfer/independent transfer height needs, frequent/urgent position changes, and weight thresholds for bariatric beds; air‑fluidized beds additionally require stage 3–4 ulcers, severely limited mobility/need to avoid institutionalization, a failed 1‑month conservative trial (q2‑hour repositioning, Group 2 surface, infection control, debridement, moist wound management), an available and trained adult caregiver, weekly licensed‑professional evaluations, monthly re‑certification/rental requests, and ruling out all alternative equipment.