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Update to ‘DME Modification Requirements Clarified for the CSHCN Services Program Effective August 1, 2020’

Last updated on 7/31/2020

This is an update to the article titled "DME Modification Requirements Clarified for the CSHCN Services Program Effective August 1, 2020," which was published on this website June 26, 2020.

The effective date has changed to September 1, 2020, and the requirements have been revised.

The following is the complete, updated article:

Effective for dates of service on or after September 1, 2020, durable medical equipment (DME) benefit information will be updated to clarify requirements for modifications for the Children with Special Health Care Needs (CSHCN) Services Program.

Repairs and modifications must be cost-effective. The cost of a new piece of equipment must be considered when the total cost of repairs and modifications will be greater than $1,000.00. The age of the current equipment and the amount of time that remains until the original equipment may be replaced (e.g., every three years for a manual wheelchair and every five years for a power wheelchair), must be considered when reviewing a request for repairs or modifications.

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.