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Durable Medical Equipment (DME)
17.1 Enrollment 17-3
17.1.1 Custom DME Requirements 17-3
17.2 Program Overview and Guidelines 17-4
17.2.1 Custom DME 17-4
17.2.2 Standard DME 17-4
17.2.3 Program Guidelines 17-5
17.3 Benefits, Limitations, and Authorization Requirements 17-5
17.3.1 Adaptive Strollers 17-6
17.3.1.1 Authorization Requirements 17-6
17.3.2 Ambulation Aids 17-6
17.3.2.1 Crutches, Walkers, Gait and Ambulation Belts, and Canes 17-6
17.3.3 Burn Care Garments 17-7
17.3.4 Cochlear Implant Device 17-7
17.3.5 Enuresis Alarms 17-7
17.3.5.1 Prior Authorization Requirements 17-7
17.3.6 Gait Trainers (Supported or Sling Walkers) 17-7
17.3.6.1 Authorization Requirements 17-7
17.3.7 Gastrostomy Devices 17-8
17.3.7.1 Authorization Requirements 17-8
17.3.7.2 Nonobturated Gastrostomy Devices 17-8
17.3.7.3 Obturated Gastrostomy Devices 17-8
17.3.8 Hospital Beds (Manual and Electric) 17-8
17.3.8.1 Authorization and Prior Authorization Requirements 17-8
17.3.8.2 Pressure Reducing Pads 17-9
17.3.8.3 Hospital Cribs and Enclosed Beds 17-9
17.3.9 Hygiene Equipment 17-10
17.3.9.1 Authorization Requirements 17-10
17.3.9.2 Adaptive Feeder Seats 17-10
17.3.9.3 Commode Chair 17-10
17.3.10 Infusion Pumps 17-12
17.3.11 Portable Paraffin Units 17-12
17.3.12 Special Needs Car Seats and Travel Restraints 17-12
17.3.12.2 Travel Restraints 17-13
17.3.13 Standers, Prone or Supine 17-13
17.3.13.1 Authorization Requirements 17-13
17.3.14 TENS Units 17-14
17.3.15 Transfer Boards 17-14
17.3.16 Travel Chairs 17-14
17.3.16.1 Prior Authorization Requirements 17-14
17.3.17 Wheelchairs 17-14
17.3.17.1 Wheelchair Authorization Requirements 17-14
17.3.17.2 Manual Wheelchairs 17-15
17.3.17.3 Custom Manual Wheelchairs 17-15
17.3.17.4 Power Wheelchairs 17-15
17.3.17.5 Approval Criteria for Power Wheelchairs 17-16
17.3.17.6 Wheelchair Positioning Equipment 17-16
17.3.18 Portable Wheelchair Ramps 17-16
17.3.19 Noncovered Rehabilitative and Therapeutic DME 17-17
17.3.20 Repairs and Modifications 17-17
17.4 Documentation of Receipt 17-17
17.5 Claims Information 17-18
17.6 Reimbursement 17-18
17.7 TMHP-CSHCN Services Program Contact Center 17-19
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