Certificate of Medical Necessity
What is a Certificate of Medical Necessity?
Medicare provides reimbursement for many types of durable medical equipment. They will typically pay 80% of the cost of an adjustable bed or mobility scooter.
Most enrolled in Medicare are eligible to receive this coverage, but must provide a doctors prescription. Some types of medical equipment, like lift chairs, require a Certificate of Medical Necessity.
A Certificate of Medical Necessity is simply a more detailed prescription that must be filled out by your doctor. Usually the company that you purchase the equipment from will provide you with the form and fill out the product information section and you must have your doctor fill out the rest.
Lift Chairs
Lift chairs are only partially covered by Medicare
In order for the chair to be covered it must use an electric lifting mechanism that operates smoothly and steadily. The lifting mechanism is the only part of the chair that is covered, which is usually around $300.
Lift chairs require a Certificate of Medical Necessity and the doctor must answer the following questions:
- Is the patient suffering from severe hip or knee arthritis?
- Is the patient suffering from a serious neuromuscular disease?
- Is it impossible for the patient to stand up from any chair in their home?
- Once standing, does the patient have the ability to move about independently?
- Has medication or therapy been used unsuccessfully to address this condition?
What Else Requires a Certificate of Medical Necessity?
- Patient Lifts (lift chairs, stair lifts, wheelchair lifts, elevators)
- Wheelchair and mobility scooters
- Oxygen supplies and equipment
- Bone growth stimulators