CSHCN 2009 > Durable Medical Equipment (DME) > Benefits, Limitations, and Authorization Requirements

17.3 Benefits, Limitations, and Authorization Requirements

The CSHCN Services Program must authorize all requests for both standard and custom DME. Requests must be submitted on the CSHCN Services Program Durable Medical Equipment Authorization Request Form.

Note: The physician's signature is only required on page 1 of the form in the Statement of Medical Necessity section. Providers must submit page 1 of the form to TMHP. Pages 2 through 5 are only required for certain DME requests. Refer to the text under the form title to determine which of these pages must be submitted in addition to page 1.

Written requests for prior authorization are required for custom manual wheelchairs, all power wheelchairs and custom seating systems, pediatric hospital cribs and protective tops, and other DME as specified in the sections below. The custom DME prior authorization period is no less than 75 days from the date of approval. If the client's eligibility is due to end before the 75 days, providers will still receive a 75-day authorization from the date of the approval.

Refer to: Chapter 4, "Authorizations and Prior Authorizations," on page 4-1 for more information about authorizations and prior authorizations.

Appendix B, "Forms," on page B-1.