Medicaid Benefits: Medical Equipment and Supplies (Other Than Through Home Health)
This data is presented as an interactive tool that allows users to: filter by timeframe/year, select specific data columns (distributions), filter by state or geography, and view the data as a table, map, or trend chart.
2018
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limits on Services | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 42 No - 3 NR - 6 | 2018 data limited to CN | Yes - 11 | Yes - 29 | Included in "Limits on Services" for 2018 | Not included in 2018 survey |
| Alabama | Yes | CN | No | NR | - | - |
| Alaska | Yes | CN | No | Requires prior authorization | - | - |
| Arizona | No | - | - | |||
| Arkansas | Yes | CN | NR | NR | - | - |
| California | Yes | CN | No | Incontinence creams and washes limited to pregnant or institutionalized adults; enteral nutrition supplements limited to specified medical conditions | - | - |
| Colorado | No | - | - | |||
| Connecticut | Yes | CN | No | One breast pump per member per every 2 years; DME/MEDS rentals beyond 3 months must be prior authorized and the cost for DME/MED rentals must not exceed the purchase price of the DME/MED item | - | - |
| Delaware | Yes | CN | No | Medically necessary | - | - |
| District of Columbia | Yes | CN | No | Requires a UR review prior to service | - | - |
| Florida | Yes | CN | No | Limits are specific to each individual service. | - | - |
| Georgia | Yes | CN | $3 copay | Medically necessary | - | - |
| Hawaii | Yes | CN | No | No | - | - |
| Idaho | Yes | CN | No | No | - | - |
| Illinois | NR | NR | NR | NR | NR | NR |
| Indiana | Yes | CN | No | Prior authorization for specified medical equipment and medical supply items. $1,950 maximum benefit/year for incontinence products and products must be obtained from a contracted vendor. | - | - |
| Iowa | NR | NR | NR | NR | NR | NR |
| Kansas | Yes | CN | $3.00 (supplies and rental are exempt) | Frequency and quantity limits vary by product; wheelchairs limited to one per 5 years if repair cost of existing chair not reasonable | - | - |
| Kentucky | Yes | CN | $4 | Limited to items used primarily in the home | - | - |
| Louisiana | Yes | CN | No | No | - | - |
| Maine | Yes | CN | $.50 to $3/day depending on payment amount, up to $30/month, no copay on oxygen equipment | Varying limits depending on item | - | - |
| Maryland | Yes | CN | NR | Some services are pre-authorized | - | - |
| Massachusetts | Yes | CN | No | No | - | - |
| Michigan | Yes | CN | No | Some items require prior authorization | - | - |
| Minnesota | Yes | CN | No | No | - | - |
| Mississippi | Yes | CN | Up to $3 per item depending on program payment | NR | - | - |
| Missouri | Yes | CN | No | No | - | - |
| Montana | Yes | CN | Income at or below 100% FPL - $4 per visit; above FPL - 10% of payment amount | Medicare criteria are followed. Sole source provider for breast pumps (limited to one per pregnancy) | - | - |
| Nebraska | Yes | CN | $3 per specified equipment, prosthetic, orthotic or other supply | Personal comfort, convenience, education, hygiene, safety, cosmetic, new equipment of unproven value, and equipment of questionable current usefulness or therapeutic value are not covered | - | - |
| Nevada | NR | NR | NR | NR | - | - |
| New Hampshire | Yes | CN | No | NR | - | - |
| New Jersey | Yes | CN | No | Quantity limits, prior authorization | - | - |
| New Mexico | Yes | CN | No | No | - | - |
| New York | NR | NR | NR | NR | - | - |
| North Carolina | Yes | CN | No | Quantity limits, life expectancies, age limits | - | - |
| North Dakota | Yes | CN | No | Prior approval required for services based on policy requirements | - | - |
| Ohio | Yes | CN | No | Multiple frequency limits are used | - | - |
| Oklahoma | Yes | CN | $4 copay per claim | Covered when prescribed by medical provider and may require prior authorization | - | - |
| Oregon | Yes | CN | No | Prior authorization required, coverage based upon the prioritized list of health services | - | - |
| Pennsylvania | Yes | CN | Purchase of DME and medical supplies is subject to sliding scale based on Medicaid fee for the service: $0.65 - $3.80. No cost sharing for rental of DME. | No | - | - |
| Rhode Island | No | - | - | |||
| South Carolina | NR | NR | NR | NR | - | - |
| South Dakota | Yes | CN | 5% of payment for med equipment or regular med supply items, $2/day enteral supplies, $5/day parenteral supplies | Some DME requires a prior authorization. | - | - |
| Tennessee | Yes | CN | No | No | - | - |
| Texas | Yes | CN | No | Requires prior authorization | - | - |
| Utah | Yes | CN | No | Limits vary by item and medical necessity | - | - |
| Vermont | Yes | CN | No | Some durable medical equipment and supplies require prior approval | - | - |
| Virginia | NR | NR | NR | NR | - | - |
| Washington | Yes | CN | No | Some require prior authorization | - | - |
| West Virginia | Yes | CN | No | Following the established capped rental timeframe (10 Months) durable medical equipment (DME) items are determined purchased. | - | - |
| Wisconsin | Yes | CN | $0.50 - $3.00 per service; rental items and repairs have no copayment | Some items require prior authorization; All DME have a published life expectancy-prior authorization required to exceed the life expectancy; most incontinence and urological supplies provided through a volume purchase contract; Some DMS have quantity limits | - | - |
| Wyoming | Yes | CN | No | Some devices require prior authorization | - | - |
2012
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limit on services days | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 56 No - 0 | Yes - 19 No - 37 | ||||
| Alabama | Yes | CN | $.50-$3/ service or item, depending on payment | Fee for service using Medicare payment ceilings, some items paid cost plus percentage | ||
| Alaska | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| American Samoa | Yes | See territory-specific FN | Most on-island services provided by LBJ Tropical Medical Center | |||
| Arizona | Yes | CN & MN | Insulin pumps and percussive vests not covered but supplies and repairs may still be reimbursed | Specified med equipment and med supply items, depending on cost | Fee for service using Medicare payment ceilings | |
| Arkansas | Yes | CN & MN | Med supplies limited to $250/month | Specified med equipment and med supply items | Fee for service for med equipment, med supplies paid up to Medicare payment ceilings | |
| California | Yes | CN & MN | Incontinence creams and washes limited to pregnant or institutionalized adults, enteral nutrition supplements limited to specified medical conditions | 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 | |
| Colorado | Yes | CN | $1/date of service | Specified med equipment and med supply items | Fee for service, some items paid retail price minus 22.97% or invoice cost plus 12.71% | |
| Connecticut | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Delaware | Yes | CN | Fee for service, using Medicare payment ceilings when available | |||
| District of Columbia | Yes | CN & MN | Repairs covered only after warranty expired and only if cost is less than 75% of purchase price, repairs not covered on rental items, diabetic supplies managed by contracted vendor | Specified med equipment and med supply items, depending on cost | Fee for service | |
| Florida | Yes | CN & MN | Limitations vary by item | Specified med equipment and med supply items | Fee for service or individually priced | |
| Georgia | Yes | CN & MN | $3/med equipment, med supply item or rental of med equipment item per month | Coverage for nursing facility residents limited to augmentative communication devices | Specified med equipment and med supply items including enteral formula | Fee for service at 80% of CMS DMEPOS 2007 rates |
| Guam | Yes | CN | Fee for service using Medicare fee schedule or negotiated rate | |||
| Hawaii | Yes | CN & MN | Items costing more than $50 | Fee for service | ||
| Idaho | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| Illinois | Yes | CN & MN | Specified med equipment and med supply items as well as repair of selected items | Fee for service | ||
| Indiana | Yes | CN | $1950 maximum benefit/year for incontinence products and products must be obtained from a contracted vendor | Specified med equipment and med supply items | Fee for service using historical Medicare payment rates | |
| Iowa | Yes | CN & MN | $2/day | Oxygen systems limited to specific medical conditions, med supplies limited to 3-month supply at one time | Specified med equipment and med supply items | Fee for service |
| Kansas | Yes | CN & MN | $3/service or item | Selected services | Reasonable charge with limits | |
| Kentucky | Yes | A, B & C - See state-specific FN | 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% | |
| Louisiana | Yes | CN & MN | Medical necessity criteria must be met and items must be part of care plan, items not covered for ICF/MR and nursing facility residents outside per diem | Yes | Fee for service, some items individually priced | |
| Maine | Yes | CN & MN | $.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip) | Varying limits depending on item, face-to-face encounter with physician or other designated provider required within 6 months prior to order for any DME, diabetic testing supplies not available from suppliers - only at pharmacies | Specified services including med equip and supplies costing more than $699 | Fee for service or contract rates |
| Maryland | Yes | CN & MN | Medical equipment coverage limited to one piece per need and use in home | Specified med equipment and med supply items depending on cost | Fee for service | |
| Massachusetts | Yes | CN & MN | Yes | Fee for service | ||
| Michigan | Yes | CN & MN | Limitations vary by type of equipment or supply | Specified med equipment and med supply items | Fee for service for most products, incontinence supplies available through state's volume purchase contractor | |
| Minnesota | Yes | A & B - See state-specific FN | Specified services | Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors | ||
| Mississippi | Yes | CN | $.50-$3/DME service or item, depending on payment; no copay for supplies | Specified items and services | Fee for service using a percentage of Medicare allowable cost as ceiling | |
| Missouri | Yes | CN | Specified items and services | Fee for service | ||
| Montana | Yes | A & B - See state-specific FN | $5/service or item | B - limited to items and services essential for employment | Med equipment or supply items costing more than $1,000 | Fee for service or percentage of charge |
| Nebraska | Yes | CN & MN | $3/specified services | Specified med equipment | Fee for service | |
| Nevada | Yes | CN | Adult diapers and incontinence pads limited to 6/day | Specified items | Fee for service | |
| New Hampshire | Yes | CN & MN | Disposable incontinence supplies, med equipment items and communication devices | Fee for service, adjusted retail price or individual pricing | ||
| New Jersey | Yes | CN & MN | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | ||
| New Mexico | Yes | CN | A - $0-$7/item, depending on income - see state-specific FN | 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 | Specified med equipment items | Fee for service using Medicare payment ceilings |
| New York | Yes | CN & MN | $1/order | Orthopedic footwear and compression stockings limited by medical condition | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage |
| North Carolina | Yes | CN & MN | Lifetime expectancy limitations applied to specified items | Specified items and services including repairs | Fee for service based on Medicare rates or reasonable cost | |
| North Dakota | Yes | CN & MN | Specified med equipment and supplies and other items costing more than $750 | Fee for service | ||
| Northern Mariana Islands | Yes | CN & MN - See territory-specific FN | 1 wheelchair/5 years, non-motorized only | Yes | ||
| Ohio | Yes | CN | 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 | ||
| Oklahoma | Yes | CN | $3/visit | Fee for service | ||
| Oregon | Yes | A & B - See state-specific FN | A & B - services limited to funded conditions on the priority list B - limited to specified diabetic, ostomy and respiratory med equipment and supplies | Specified med equipment and med supply items | Fee for service, using a percentage of Medicare rates | |
| Pennsylvania | Yes | CN & MN | $.65-$3.80/service, depending on payment rate for purchased items only, not applicable to oxygen | MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care | For equipment other than oxygen | Fee for service |
| Puerto Rico | Yes | CN & MN | Med equipment limited to life-saving items | Service is included in the capitated rate paid to managed care plans | ||
| Rhode Island | Yes | See state-specific FN | Coverage of molded shoes varies by group | Yes | Fee for service or reasonable charge with ceilings | |
| South Carolina | Yes | CN | $3.40/provider/day | Heavy duty equipment | Fee for service using a percentage of Medicare payment rates as a ceiling | |
| South Dakota | Yes | CN | 5% of payment for med equipment or regular med supply item, $2/day enteral supplies, $5/day parenteral supplies | Fee for service, some items paid percentage of charge | ||
| Tennessee | Yes | A, B & C - See state-specific FN | See state-specific FN | |||
| Texas | Yes | CN & MN | Wheeled mobility devices covered only after assessment by qualified rehab professional | Specified items | Fee for service | |
| Utah | Yes | A, B & C - See state-specific FN | C - 10% of payment for item | B & C - limited list of covered equipment and supplies | Specified med equipment and supply items | Fee for service, wheelchairs paid discounted price plus design fee, augmentative communication devices paid percentage of list price with limits |
| Vermont | Yes | A & B - See state-specific FN | $1-$3/service or item, depending on payment | B - only covered under PC Plus | Specified med equipment and med supply items | Fee for service |
| U.S. Virgin Islands | Yes | CN | Yes | Fee for service | ||
| Virginia | Yes | CN & MN | Limits vary by item | Specified items | Fee for service, home infusion therapy paid per diem | |
| Washington | Yes | CN & MN | Quantity and frequency limits vary by item; oral enteral nutrition, TENS, automated blood pressure cuffs, bath and shower equipment and support stockings not covered | Specified med equipment and supply items | Fee for service | |
| West Virginia | Yes | A, B & C | A - $1,000/year unless additional coverage authorized | Yes | Fee for service using a percentage of Medicare rates | |
| Wisconsin | Yes | CN & MN | $.50-$3, depending on service or item; $.50/Rx for diabetic supplies; no copays required on rented DME | Limited items available to nursing facility residents | Specified med equipment and med supply items, depending on cost | Fee for service for med equipment, med supplies paid cost plus mark-up |
| Wyoming | Yes | CN | Specified items and services | Fee for service, some items paid acquisition cost plus 15% shipping and handling charge |
2010
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limit on services days | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 56 No - 0 | Yes - 17 No - 39 | ||||
| Alabama | Yes | CN | $1-$3/ service or item, depending on payment | Fee for service using Medicare payment ceilings, some items paid cost plus percentage | ||
| Alaska | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| American Samoa | Yes | See territory-specific FN | ||||
| Arizona | Yes | CN & MN | Insulin pumps and percussive vests not covered but supplies and repairs may still be reimbursed | Specified med equipment and med supply items, depending on cost | Fee for service using Medicare payment ceilings | |
| Arkansas | Yes | CN & MN | Med supplies limited to $250/month | Specified med equipment and med supply items | Fee for service for med equipment, med supplies paid up to Medicare payment ceilings | |
| California | Yes | CN & MN | Incontinence creams and washes limited to pregnant or institutionalized adults | 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 | |
| Colorado | Yes | CN | $1/date of service | Specified med equipment and med supply items | Fee for service, some items paid retail price minus 22.39% or invoice cost plus 13.56% | |
| Connecticut | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Delaware | Yes | CN | Fee for service, using Medicare payment ceilings when available | |||
| District of Columbia | Yes | CN & MN | Specified med equipment and med supply items, depending on cost | Fee for service | ||
| Florida | Yes | CN & MN | Limitations vary by item | Specified med equipment and med supply items | Fee for service or individually priced | |
| Georgia | Yes | CN & MN | $3/med equipment item, $1/med supply item or rental of med equipment item per month | Coverage for nursing facility residents limited to augmentative communication devices | Specified med equipment and med supply items including enteral formula | Fee for service at 80% of CMS 2007 rates |
| Guam | Yes | CN | Fee for service | |||
| Hawaii | Yes | CN & MN | Items costing more than $50 | Fee for service | ||
| Idaho | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| Illinois | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Indiana | Yes | CN | $1950 maximum benefit/year for incontinence products and products must be obtained from a contracted vendor | Specified med equipment and med supply items | Fee for service using historical Medicare payment rates | |
| Iowa | Yes | CN & MN | $2/day | Oxygen systems limited to specific medical conditions, med supplies limited to 3-month supply | Specified med equipment and med supply items | Fee for service |
| Kansas | Yes | CN & MN | $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 | |
| Kentucky | Yes | A, B & C - See state-specific FN | 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% | |
| Louisiana | Yes | CN & MN | Yes | Fee for service, some items individually priced | ||
| Maine | Yes | CN & MN | $.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip) | Varying limits depending on item | Specified services | Fee for service or contract rates |
| Maryland | Yes | CN & MN | Medical equipment coverage limited to one piece per need and use in home | Specified med equipment and med supply items depending on cost | Fee for service | |
| Massachusetts | Yes | CN & MN | Yes | Fee for service | ||
| Michigan | Yes | CN & MN | Limitations vary by type of equipment or supply | Specified med equipment and med supply items | Fee for service for most products, incontinence supplies available through state's volume purchase contractor | |
| Minnesota | Yes | A & B - See state-specific FN | Specified services | Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors | ||
| Mississippi | Yes | CN | $.50-$3/DME service or item, depending on payment; no copay for supplies | Med equipment | Fee for service using a percentage of Medicare allowable cost as ceiling | |
| Missouri | Yes | CN | Adult coverage other than for pregnant or blind limited to specified items unless provided through home health plan of care | Yes | Fee for service | |
| Montana | Yes | A & B - See state-specific FN | $5/service or item | Med equipment or supply items costing more than $1,000 | Fee for service or percentage of charge | |
| Nebraska | Yes | CN & MN | Specified med equipment | Fee for service | ||
| Nevada | Yes | CN | Adult diapers and incontinence pads limited to 6/day | Specified items | Fee for service | |
| New Hampshire | Yes | CN & MN | Disposable incontinence supplies and med equipment items | Fee for service, adjusted retail price or individual pricing | ||
| New Jersey | Yes | CN & MN | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | ||
| New Mexico | Yes | CN | A - $0-$7/item, depending on income - see state-specific FN | 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 | Specified med equipment items | Fee for service using Medicare payment ceilings |
| New York | Yes | CN & MN | $1/order | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | |
| North Carolina | Yes | CN & MN | Lifetime expectancy limitations applied to specified items | Specified items and services including repairs | Fee for service based on Medicare rates or reasonable cost | |
| North Dakota | Yes | CN & MN | Specified med equipment and supplies and other items costing more than $750 | Fee for service | ||
| Northern Mariana Islands | Yes | CN & MN - See territory-specific FN | 1 wheelchair/5 years, non-motorized only | Yes | ||
| Ohio | Yes | CN | 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 | ||
| Oklahoma | Yes | CN | $3/visit | Fee for service | ||
| Oregon | Yes | A & B - See state-specific FN | A & B - services limited to funded conditions on the priority list B - limited to specified diabetic, ostomy and respiratory med equipment and supplies | Specified med equipment and med supply items | Fee for service, using a percentage of Medicare rates | |
| Pennsylvania | Yes | CN & MN | $.50-$3/service, depending on payment rate for purchased items only, not applicable to oxygen | MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care | For equipment other than oxygen | Fee for service |
| Puerto Rico | Yes | CN & MN | Med equipment limited to life-saving items | Service is included in the capitated rate paid to managed care plans | ||
| Rhode Island | Yes | See state-specific FN | Coverage of molded shoes varies by group | Yes | Fee for service or reasonable charge with ceilings | |
| South Carolina | Yes | CN | $3/provider/day | Fee for service using a percentage of Medicare payment rates as a ceiling | ||
| South Dakota | Yes | CN | 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 | ||
| Tennessee | Yes | A & B - See state-specific FN | See state-specific FN | |||
| Texas | Yes | CN & MN | Specified items | Fee for service | ||
| Utah | Yes | A, B & C - See state-specific FN | C - 10% of payment for item | B & C - limited list of covered equipment and supplies | Specified med equipment and supply items | Fee for service, wheelchairs paid discounted price plus design fee, augmentative communication devices paid percentage of list price with limits |
| Vermont | Yes | A & B - See state-specific FN | B - only covered under PC Plus | Specified med equipment and med supply items | Fee for service | |
| U.S. Virgin Islands | Yes | CN | Yes | Fee for service | ||
| Virginia | Yes | CN & MN | Limits vary by item | Specified items | Fee for service, home infusion therapy paid per diem | |
| Washington | Yes | CN & MN | Quantity and frequency limits vary by item; oral enteral nutrition, TENS, automated blood pressure cuffs, bath and shower equipment and support stockings not covered | Specified med equipment and supply items | Fee for service | |
| West Virginia | Yes | A, B & C | A - $1,000/year unless additional coverage authorized | Yes | Fee for service using a percentage of Medicare rates | |
| Wisconsin | Yes | CN & MN | $.50-$3, depending on service or item | Limited items available to nursing facility residents | Specified med equipment and med supply items, depending on cost | Fee for service for med equipment, med supplies paid cost plus mark-up |
| Wyoming | Yes | CN | Specified items and services | Fee for service, some items paid acquisition cost plus 15% shipping and handling charge |
2008
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limit on services days | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 55 No - 1 | Yes - 15 No - 40 | ||||
| Alabama | Yes | CN | $1-$3/ service or item, depending on payment | Fee for service using Medicare payment ceilings, some items paid cost plus percentage | ||
| Alaska | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| American Samoa | Yes | See territory-specific FN | ||||
| Arizona | Yes | CN & MN | 1 med equipment purchase of the same type/2 years | Specified med equipment and med supply items, depending on cost | Fee for service using Medicare payment ceilings | |
| Arkansas | Yes | CN & MN | Med supplies limited to $250/month | Specified med equipment and med supply items | Fee for service for med equipment, med supplies paid up to Medicare payment ceilings | |
| California | Yes | CN & MN | 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 | ||
| Colorado | Yes | CN | $1/date of service | Specified med equipment and med supply items | Fee for service | |
| Connecticut | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Delaware | Yes | CN | Fee for service, using Medicare payment ceilings when available | |||
| District of Columbia | Yes | CN & MN | Specified med equipment and med supply items, depending on cost | Fee for service | ||
| Florida | Yes | CN & MN | Limitations vary by item | Specified med equipment and med supply items | Fee for service or individually priced | |
| Georgia | Yes | CN & MN | $3/med equipment item, $1/med supply item or rental of med equipment item per month | Coverage for nursing facility residents limited to augmentative communication devices | Specified med equipment and med supply items including enteral formula | Fee for service at 80% of CMS 2007 rates |
| Guam | Yes | CN | Fee for service | |||
| Hawaii | Yes | CN & MN | Specified items | Fee for service | ||
| Idaho | Yes | CN | Specified med equipment and med supply items, | Fee for service | ||
| Illinois | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Indiana | Yes | CN | $1950 maximum benefit/year for incontinence products and products must be obtained from a contracted vendor | Specified med equipment and med supply items | Fee for service using historical Medicare payment rates | |
| Iowa | Yes | CN & MN | $2/day | Oxygen systems limited to specific medical conditions, med supplies limited to 3 month supply | Specified med equipment and med supply items | Fee for service |
| Kansas | Yes | CN & MN | $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 | |
| Kentucky | Yes | A, B & C - See state-specific FN | A & C - 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% | |
| Louisiana | Yes | CN & MN | Yes | Fee for service, some items individually priced | ||
| Maine | Yes | CN & MN | $.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip) | Varying limits depending on item | Specified services | Fee for service |
| Maryland | Yes | CN & MN | Medical equipment coverage limited to one piece per need and use in home | Specified med equipment and med supply items, depending on cost | Fee for service | |
| Massachusetts | Yes | CN & MN | Yes | Fee for service | ||
| Michigan | Yes | CN & MN | Limitations vary by type of equipment or supply | Specified med equipment and med supply items | Fee for service for most products, incontinence supplies available through state's volume purchase contractor | |
| Minnesota | Yes | A & B - See state-specific FN | Specified services | Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors | ||
| Mississippi | Yes | CN | $.50-$3/DME service or item, depending on payment | Yes | Fee for service using a percentage of Medicare allowable cost as ceiling | |
| Missouri | Yes | CN | Adult coverage other than for pregnant or blind limited to specified items unless provided through home health plan of care | Yes | Fee for service | |
| Montana | Yes | A & B - See state-specific FN | $5/service or item | Med equipment or supply items costing more than $1,000 | Fee for service or percentage of charge | |
| Nebraska | Yes | CN & MN | Specified med equipment and med supply items costing more than $500 | Fee for service | ||
| Nevada | Yes | CN | Specified items | Fee for service | ||
| New Hampshire | Yes | CN & MN | Disposable incontinence supplies and med equipment items | Fee for service, adjusted retail price or individual pricing | ||
| New Jersey | Yes | CN & MN | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | ||
| New Mexico | Yes | CN | 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 | Specified med equipment items | Fee for service using Medicare payment ceilings | |
| New York | Yes | CN & MN | $1/order | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | |
| North Carolina | Yes | CN & MN | Lifetime expectancy limitations applied to specified items | Specified items and services including repairs | Fee for service based on Medicare rates or reasonable cost | |
| North Dakota | Yes | CN & MN | Med equipment or med supply items costing more than $500 | Fee for service | ||
| Northern Mariana Islands | Yes | CN & MN - See territory-specific FN | 1 wheelchair/5 years, non-motorized only | Yes | ||
| Ohio | Yes | CN | 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 | ||
| Oklahoma | Yes | CN | Fee for service | |||
| Oregon | Yes | A & B - See state-specific FN | B - limited to specified diabetic, ostomy and respiratory med equipment and supplies | Specified med equipment and med supply items | Fee for service | |
| Pennsylvania | Yes | CN & MN | $.50-$3/service, depending on payment rate for purchased items only, not applicable to oxygen | MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care | For equipment other than oxygen | Fee for service |
| Puerto Rico | No | |||||
| Rhode Island | Yes | CN & MN - see state-specific FN | Coverage of molded shoes varies by group | Yes | Fee for service or reasonable charge with ceilings | |
| South Carolina | Yes | CN | $3/provider/day | Fee for service using a percentage of Medicare payment rates as a ceiling | ||
| South Dakota | Yes | CN | 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 | ||
| Tennessee | Yes | A & B - See state-specific FN | ||||
| Texas | Yes | CN & MN | Specified items | Fee for service | ||
| Utah | Yes | A, B & C - See state-specific FN | C - 10% of payment for item | B & C - limited list of covered equipment and supplies | Specified med equipment and med supply items | Fee for service, wheelchairs paid discounted price plus design fee, augmentative communication devices paid percentage of list price with limits |
| Vermont | Yes | A & B - See state-specific FN | B - only covered under PC Plus | Specified med equipment and med supply items | Fee for service | |
| U.S. Virgin Islands | Yes | CN | Yes | Fee for service | ||
| Virginia | Yes | CN & MN | Limits vary by item | Specified items | Fee for service, home infusion therapy paid per diem | |
| Washington | Yes | CN & MN | Quantity and frequency limits vary by item | Specified med equipment and med supply items | Fee for service | |
| West Virginia | Yes | A, B & C | A - $1,000/year | Yes | Fee for service using a percentage of Medicare rates | |
| Wisconsin | Yes | CN & MN | $.50-$3, depending on service or item | Limited items available to nursing facility residents | Specified med equipment and med supply items, depending on cost | Fee for service for med equipment, med supplies paid cost plus mark-up |
| Wyoming | Yes | CN | Specified items and services | Fee for service, some items paid acquisition cost plus 15% shipping and handling charge |
2006
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limit on services days | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 55 No - 1 | Yes - 15 No - 40 | ||||
| Alabama | Yes | CN | $3/med equipment item, $.50-$1/med supply item | Fee for service using Medicare payment ceilings, some items paid cost plus percentage | ||
| Alaska | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| American Samoa | Yes | See territory-specific FN | ||||
| Arizona | Yes | CN & MN | 1 med equipment purchase of the same type/2 years | Specified med equipment and med supply items, depending on cost | Fee for service using Medicare payment ceilings | |
| Arkansas | Yes | CN & MN | Med supplies limited to $250/month | Specified med equipment and med supply items | Fee for service for med equipment, med supplies paid up to Medicare payment ceilings | |
| California | Yes | CN & MN | 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 | ||
| Colorado | Yes | CN | $1/date of service | Specified med equipment and med supply items | Fee for service | |
| Connecticut | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Delaware | Yes | CN | Fee for service, using Medicare payment ceilings when available | |||
| District of Columbia | Yes | CN & MN | Specified med equipment and med supply items, depending on cost | Fee for service | ||
| Florida | Yes | CN & MN | Limitations vary by item | Specified med equipment and med supply items | Fee for service or individually priced | |
| Georgia | Yes | CN & MN | $3/med equipment item, $1/med supply item or rental of med equipment item per month | Coverage for nursing facility residents limited to augmentative communication devices | Specified med equipment and med supply items including enteral formula | Fee for service |
| Guam | Yes | CN | Fee for service | |||
| Hawaii | Yes | CN & MN | Fee for service | |||
| Idaho | Yes | CN | Incontinent supplies limited by beneficiary age and quantity, oxygen and related equipment limited to specific medical conditions | Specified med equipment and med supply items, including oxygen systems | Fee for service, med equipment rental paid at 1/10 purchase price for 10 months | |
| Illinois | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Indiana | Yes | CN | Specified med equipment and med supply items | Fee for service using historical Medicare payment rates | ||
| Iowa | Yes | CN & MN | $2/day | Oxygen systems limited to specific medical conditions, med supplies limited to 3 month supply | Specified med equipment and med supply items | Fee for service |
| Kansas | Yes | CN & MN | $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 | |
| Kentucky | Yes | A, B & C - See state-specific FN | A & C - 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% | |
| Louisiana | Yes | CN & MN | Yes | Fee for service, some items individually priced | ||
| Maine | Yes | CN & MN | $.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip) | Orthopedic footwear 1 item/year; shoe modifications 2 inches/year; 8 lifts/year | Fee for service | |
| Maryland | Yes | CN & MN | Medical equipment coverage limited to one piece per need and use in home | Specified med equipment and med supply items, depending on cost | Fee for service | |
| Massachusetts | Yes | CN & MN | Yes | Fee for service | ||
| Michigan | Yes | CN & MN | Specified med equipment and med supply items | Fee for service for most products, incontinence supplies available through state's volume purchase contractor | ||
| Minnesota | Yes | A & B - See state-specific FN | Specified services | Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors | ||
| Mississippi | Yes | CN | $.50-$3/DME service or item, depending on payment | Yes | Fee for service using a percentage of Medicare allowable cost as ceiling | |
| Missouri | Yes | CN | Adult coverage other than for pregnant or blind limited to specified items unless provided through home health plan of care | Yes | Fee for service | |
| Montana | Yes | A & B - See state-specific FN | $5/service or item | Med equipment or supply items costing more than $1,000 | Fee for service or percentage of charge | |
| Nebraska | Yes | CN & MN | Specified med equipment and med supply items costing more than $500 | Fee for service | ||
| Nevada | Yes | CN | Fee for service | |||
| New Hampshire | Yes | CN & MN | Oxygen and specified med equipment items | Fee for service | ||
| New Jersey | Yes | CN & MN | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | ||
| New Mexico | Yes | CN | 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 | Specified med equipment items | Fee for service using Medicare payment ceilings | |
| New York | Yes | CN & MN | $1/order | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | |
| North Carolina | Yes | CN & MN | Lifetime expectancy limitations applied to specified items | Specified items and services including repairs | Fee for service | |
| North Dakota | Yes | CN & MN | Med equipment or med supply items costing more than $200 | Fee for service using a percentage of Medicare allowable cost as ceiling | ||
| Northern Mariana Islands | Yes | CN & MN - See territory-specific FN | 1 wheelchair/5 years, non-motorized only | Yes | ||
| Ohio | Yes | CN | Specified med equipment and supply items, repairs costing more than $100 | Fee for service, some items paid percentage of item's list price | ||
| Oklahoma | Yes | CN | Fee for service | |||
| Oregon | Yes | A & B - See state-specific FN | B - limited to specified diabetic, ostomy and respiratory med equipment and supplies | Specified med equipment and med supply items | Fee for service | |
| Pennsylvania | Yes | CN & MN | $.50-$3/service, depending on payment for purchased items only | MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care | Fee for service | |
| Puerto Rico | No | |||||
| Rhode Island | Yes | CN & MN - see state-specific FN | Coverage of molded shoes varies by group | Yes | Fee for service or reasonable charge with ceilings | |
| South Carolina | Yes | CN | $3/provider/day | Fee for service using Medicare payment ceilings | ||
| South Dakota | Yes | CN | 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 | ||
| Tennessee | Yes | A & B - See state-specific FN | ||||
| Texas | Yes | CN & MN | Specified items | Fee for service | ||
| Utah | Yes | A, B & C - See state-specific FN | C - 10% of payment for item | B & C - limited list of covered equipment and supplies | Specified med equipment and med supply items | Fee for service, wheelchairs paid discounted price plus design fee, augmentative communication devices paid percentage of list price with limits |
| Vermont | Yes | A & B - See state-specific FN | B - only covered under PC Plus | Specified med equipment and med supply items | Fee for service | |
| U.S. Virgin Islands | Yes | CN | Yes | Fee for service | ||
| Virginia | Yes | CN & MN | Specified items | Fee for service, home infusion therapy paid per diem | ||
| Washington | Yes | CN & MN | Quantity and frequency limits vary by item | Specified med equipment and med supply items | Fee for service | |
| West Virginia | Yes | CN & MN | Yes | Fee for service using a percentage of Medicare rates | ||
| Wisconsin | Yes | CN & MN | $.50-$3, depending on service or item | Limited items available to nursing facility residents | Specified med equipment and med supply items, depending on cost | Fee for service for med equipment, med supplies paid cost plus mark-up |
| Wyoming | Yes | CN | Specified items and services | Fee for service, some items paid acquisition cost plus 15% shipping and handling charge |
2004
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limit on services days | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 55 No - 1 | Yes - 13 No - 42 | ||||
| Alabama | Yes | CN | $3/med equipment item, $1/med supply item | Fee for service using Medicare payment ceilings, some items paid cost plus percentage | ||
| Alaska | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| American Samoa | Yes | See territory-specific FN | ||||
| Arizona | Yes | CN & MN | 1 med equipment purchase of the same type/2 years | Specified med equipment and med supply items, depending on cost | Fee for service using Medicare payment ceilings | |
| Arkansas | Yes | CN & MN | Med supplies limited to $250/month | Specified med equipment and med supply items | Fee for service for med equipment, med supplies paid up to Medicare payment ceilings | |
| California | Yes | CN & MN | 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 | ||
| Colorado | Yes | CN | $1/date of service | Specified med equipment and med supply items | Fee for service | |
| Connecticut | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Delaware | Yes | CN | Fee for service, using Medicare payment ceilings when available | |||
| District of Columbia | Yes | CN & MN | Specified med equipment and med supply items, depending on cost | Fee for service | ||
| Florida | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Georgia | Yes | CN & MN | $3/med equipment item, $1/med supply item or rental of med equipment item per month | Coverage for nursing facility residents limited to augmentative communication devices | Specified med equipment and med supply items including enteral formula | Fee for service |
| Guam | Yes | CN | Fee for service | |||
| Hawaii | Yes | CN & MN | Fee for service | |||
| Idaho | Yes | CN | Incontinent supplies limited by beneficiary age and quantity, oxygen and related equipment limited to specific medical conditions | Specified med equipment and med supply items, including oxygen systems | Fee for service, med equipment rental paid at 1/10 purchase price for 10 months | |
| Illinois | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Indiana | Yes | CN | Specified med equipment and med supply items | Fee for service using historical Medicare payment rates | ||
| Iowa | Yes | CN & MN | $2/day | Oxygen systems limited to specific medical conditions, med supplies limited to 3 month supply | Specified med equipment and med supply items | Fee for service |
| Kansas | Yes | CN & MN | $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 | |
| Kentucky | Yes | CN & MN | 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% | ||
| Louisiana | Yes | CN & MN | Yes | Fee for service, some items individually priced | ||
| Maine | Yes | CN & MN | $.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip) | Fee for service | ||
| Maryland | Yes | CN & MN | Medical equipment coverage limited to one piece per need and use in home | Specified med equipment and med supply items, depending on cost | Fee for service | |
| Massachusetts | Yes | CN & MN | Yes | Fee for service | ||
| Michigan | Yes | CN & MN | Specified med equipment and med supply items | Fee for service for most products, incontinence supplies available through state's volume purchase contractor | ||
| Minnesota | Yes | A & B - See state-specific FN | Specified services | Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors | ||
| Mississippi | Yes | CN | $.50-$3/DME service or item, depending on payment | Yes | Fee for service using a percentage of Medicare allowable cost as ceiling | |
| Missouri | Yes | CN | Yes | Fee for service | ||
| Montana | Yes | A & B - See state-specific FN | $5/service or item | Med equipment or supply items costing more than $1,000 | Fee for service or percentage of charge | |
| Nebraska | Yes | CN & MN | Specified med equipment and med supply items costing more than $500 | Fee for service | ||
| Nevada | Yes | CN | Fee for service | |||
| New Hampshire | Yes | CN & MN | Oxygen and specified med equipment items | Fee for service | ||
| New Jersey | Yes | CN & MN | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | ||
| New Mexico | Yes | CN | 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 | Specified med equipment items | Fee for service using Medicare payment ceilings | |
| New York | Yes | CN & MN | $1/order | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | |
| North Carolina | Yes | CN & MN | Lifetime expectancy limitations applied to specified items | Specified items and services including repairs | Fee for service | |
| North Dakota | Yes | CN & MN | Med equipment or med supply items costing more than $200 | Fee for service using a percentage of Medicare allowable cost as ceiling | ||
| Northern Mariana Islands | Yes | CN & MN - See territory-specific FN | 1 wheelchair/5 years, non-motorized only | Yes | ||
| Ohio | Yes | CN | Specified med equipment and supply items, repairs costing more than $100 | Fee for service, some items paid percentage of item's list price | ||
| Oklahoma | Yes | CN | Fee for service | |||
| Oregon | Yes | A & B - See state-specific FN | B - limited to specified diabetic, ostomy and respiratory med equipment and supplies | Specified med equipment and med supply items | Fee for service | |
| Pennsylvania | Yes | CN & MN | MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care | Fee for service | ||
| Puerto Rico | No | |||||
| Rhode Island | Yes | CN & MN - see state-specific FN | Yes | Reasonable charge with ceilings | ||
| South Carolina | Yes | CN | $3/provider/day | Fee for service using Medicare payment ceilings | ||
| South Dakota | Yes | CN | 5% of payment for med equipment item, $1/med supply item | Fee for service, some items paid percentage of charge | ||
| Tennessee | Yes | A & B - See state-specific FN | ||||
| Texas | Yes | CN & MN | Parenteral therapy | Fee for service or global reimbursement | ||
| Utah | Yes | A, B & C - See state-specific FN | C - 10% of payment for item | B & C - limited list of covered equipment and supplies | Specified med equipment and med supply items | Fee for service, wheelchairs paid discounted price plus design fee, augmentative communication devices paid percentage of list price with limits |
| Vermont | Yes | A & B - See state-specific FN | Specified med equipment and med supply items | Fee for service | ||
| U.S. Virgin Islands | Yes | CN | Yes | Fee for service | ||
| Virginia | Yes | CN & MN | Fee for service, home infusion therapy paid per diem | |||
| Washington | Yes | CN & MN | Quantity and frequency limits vary by item | Specified med equipment and med supply items | Fee for service | |
| West Virginia | Yes | CN & MN | Fee for service using a percentage of Medicare rates | |||
| Wisconsin | Yes | CN & MN | $.50-$3, depending on service or item | Limited items available to nursing facility residents | Specified med equipment and med supply items, depending on cost | Fee for service for med equipment, med supplies paid cost plus mark-up |
| Wyoming | Yes | CN | Specified items and services | Fee for service, some items paid acquisition cost plus shipping and handling charge |
2003
| Location | Benefit Covered | Coverage Code | Copayment Required? | Limit on services days | Prior Approval Required | Reimbursement Methodology |
|---|---|---|---|---|---|---|
| United States | Yes - 54 No - 2 | Yes - 11 No - 43 | ||||
| Alabama | Yes | CN | $3/med equipment item, $1/med supply item | Fee for service using Medicare payment ceilings, some items paid cost plus percentage | ||
| Alaska | Yes | CN | Fee for service | |||
| American Samoa | Yes | See territory-specific FN | ||||
| Arizona | Yes | CN & MN | 1 med equipment purchase of the same type/2 years | Specified med equipment and med supply items, depending on cost | Fee for service using Medicare payment ceilings | |
| Arkansas | Yes | CN & MN | Med supplies limited to $250/month | Specified med equipment and med supply items | Fee for service for med equipment, med supplies paid up to Medicare payment ceilings | |
| California | Yes | CN & MN | 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 | ||
| Colorado | Yes | CN | Specified med equipment and med supply items | Fee for service | ||
| Connecticut | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Delaware | Yes | CN | Fee for service, using Medicare payment ceilings when available | |||
| District of Columbia | Yes | CN & MN | Specified med equipment and med supply items, depending on cost | Fee for service | ||
| Florida | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Georgia | Yes | CN & MN | $3/med equipment item, $1/med supply item or rental of med equipment item per month | Coverage for nursing facility residents limited to augmentative communication devices | Specified med equipment and med supply items including enteral formula | Fee for service |
| Guam | Yes | CN | Fee for service | |||
| Hawaii | Yes | CN & MN | Fee for service | |||
| Idaho | Yes | CN | Incontinent supplies limited by beneficiary age and quantity, oxygen and related equipment limited to specific medical conditions | Specified med equipment and med supply items, including oxygen systems | Fee for service, med equipment rental paid at 1/10 purchase price for 10 months | |
| Illinois | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Indiana | Yes | CN | Specified med equipment and med supply items | Fee for service using historical Medicare payment rates | ||
| Iowa | Yes | CN & MN | $2/day | Oxygen systems limited to specific medical conditions, med supplies limited to 3 month supply | Specified med equipment and med supply items | Fee for service |
| Kansas | Yes | CN & MN | $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 | |
| Kentucky | Yes | CN & MN | Limited to items used in the home and in accordance with restrictions contained in state regulations | Fee for service using Medicare upper limits | ||
| Louisiana | Yes | CN & MN | Yes | Fee for service, some items individually priced | ||
| Maine | Yes | CN & MN | $.50-$3/day, depending on payment, up to $30/month (not applicable to oxygen and related equip) | Fee for service | ||
| Maryland | Yes | CN & MN | Medical equipment coverage limited to one piece per need and use in home | Specified med equipment and med supply items, depending on cost | Fee for service | |
| Massachusetts | Yes | CN & MN | Yes | Fee for service | ||
| Michigan | Yes | CN & MN | Specified med equipment and med supply items | Fee for service for most products, incontinence supplies available through state's volume purchase contractor | ||
| Minnesota | Yes | A & B - See state-specific FN | Specified services | Fee for service for most products, oxygen delivery systems available through state's volume purchase contractors | ||
| Mississippi | Yes | CN | $.50-$3/DME service or item, depending on payment | Yes | Fee for service using a percentage of Medicare allowable cost as ceiling | |
| Missouri | Yes | CN | Yes | Fee for service | ||
| Montana | Yes | CN & MN | $5/service or item | Med equipment or supply items costing more than $1,000 | Fee for service or percentage of charge | |
| Nebraska | Yes | CN & MN | Specified med equipment and med supply items costing more than $500 | Fee for service | ||
| Nevada | Yes | CN | Fee for service | |||
| New Hampshire | Yes | CN & MN | Oxygen and specified med equipment items | Fee for service | ||
| New Jersey | Yes | CN & MN | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | ||
| New Mexico | Yes | CN | Specified med equipment items | Fee for service using Medicare payment ceilings | ||
| New York | Yes | CN & MN | $1/order | Specified med equipment and med supply items | Fee for service, some items paid invoice cost plus percentage | |
| North Carolina | Yes | CN & MN | Lifetime expectancy limitations applied to specified items | Specified items and services including repairs | Fee for service | |
| North Dakota | Yes | CN & MN | Med equipment or med supply items costing more than $200 | Fee for service using a percentage of Medicare allowable cost as ceiling | ||
| Northern Mariana Islands | Yes | CN & MN - See territory-specific FN | 1 wheelchair/5 years, non-motorized only | Yes | ||
| Ohio | Yes | CN | Specified med equipment and supply items, repairs costing more than $100 | Fee for service, some items paid percentage of item's list price | ||
| Oklahoma | Yes | CN | Fee for service | |||
| Oregon | Yes | CN & MN | Specified med equipment and med supply items | Fee for service | ||
| Pennsylvania | Yes | CN & MN | MN: limited to items related to family planning and to medically necessary items for beneficiaries receiving home health care | Fee for service | ||
| Puerto Rico | No | |||||
| Rhode Island | Yes | CN & MN - see state-specific FN | Yes | Reasonable charge with ceilings | ||
| South Carolina | Yes | CN | Fee for service using Medicare payment ceilings | |||
| South Dakota | Yes | CN | 5% of payment for med equipment item, $1/med supply item | Fee for service, some items paid percentage of charge | ||
| Tennessee | Yes | A & B - See state-specific FN | ||||
| Texas | Yes | CN & MN | Parenteral therapy | Fee for service or global reimbursement | ||
| Utah | Yes | A, B & C - See state specific FN | C - 10% of payment for item | B & C - limited list of covered equipment and supplies | Specified med equipment and med supply items | Fee for service, wheelchairs paid discounted price plus design fee |
| Vermont | Yes | A & B - See state-specific FN | Specified med equipment and med supply items | Fee for service | ||
| U.S. Virgin Islands | Yes | CN | Yes | Fee for service | ||
| Virginia | Yes | CN & MN | Fee for service, home infusion therapy paid per diem | |||
| Washington | Yes | CN & MN | Quantity and frequency limits vary by item | Specified med equipment and med supply items | Fee for service | |
| West Virginia | No | |||||
| Wisconsin | Yes | CN & MN | $.50-$3, depending on service or item | Limited items available to nursing facility residents | Specified med equipment and med supply items, depending on cost | Fee for service for med equipment, med supplies paid cost plus mark-up |
| Wyoming | Yes | CN | Specified items and services | Fee for service, some items paid acquisition cost plus shipping and handling charge |