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Medicare Face-to-Face Requirements

For certain specified items of durable medical equipment, the Affordable Care Act requires:
  1. An in-person, face-to-face examination with the treating practitioner (Medical Doctor (MD), Doctor of Osteopathic Medicine (DO) or Doctor of Podiatric Medicine (DPM), physician assistant (PA), nurse practitioner (NP) or clinical nurse specialist (CNS))* and,
  2. The treating practitioner must document that the beneficiary was evaluated and/or treated for a condition thatsupports the need for the item(s) of DME ordered; and,

The face-to-face examination must have occurred sometime during the six (6) months prior to the date of the order for the item.

For a quick reference guide on face-to-face evaluations click here

Commonly prescribed medical equipment that require a face-to-face evaluation include:

  • CPAP machines- click here for more information

  • Oxygen concentrators- click here for more information

  • Oxygen gas bottles- click here for more information

  • Manual wheelchairs- click here for more information

  • Nebulizers- click here for more information

  • Hospital beds- click here for more information

  • Pneumatic compression devices- click here for more information

  • TENS units- click here for more information

11116 Medical Campus Road
Hagerstown, MD 21742
301-790-8000
TDD: 1-800-735-2258
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