Replacement and Continued Use of Durable Medical Equipment (DME) - DME.GG.101.A

Continued rental and replacement of DME are covered when the patient has a recent treating-practitioner visit and a documented care plan supporting device use, and replacement additionally requires clinical documentation that the device is unusable due to clinical change, lost/stolen, or broken/unrepairable and out of warranty (see individual policies for rental limits and Reasonable Useful Lifetime, typically 3–5 years). Exclusions/limitations: no separate payment while an item is actively rented, no payment for repairs that exceed the cost of replacement or for misuse/abuse, and all claims must meet Medicare LCA documentation and warranty/rental-status requirements.

"Continued rental of DME after the initial rental period is indicated when the individual has been seen recently by their treating practitioner and has a documented care plan that includes the use o..."