Medicare Claims Processing Manual (Pub. 100-04), Ch. 36 § 40.3.2.2
Payment for Inexpensive or Routinely Purchased Items
40.3.2.2 – Payment for Inexpensive or Routinely Purchased Items
(Rev. 3593, Issued: 08-17-16, Effective: 10-01-16, Implementation: 10-03-16)
For rented, grandfathered equipment in the inexpensive or routinely purchased payment class,
after the total payments for the rented, grandfathered equipment (e.g., folding walker) reach the
purchase fee schedule amount for the grandfathered equipment and after the rental payment cap
on the accessory (when applicable), the beneficiary must obtain covered accessories (e.g., seat
attachment) and supplies only from a contract supplier. The supplier of the grandfathered
equipment is no longer permitted to furnish the covered accessories and supplies once the capped
rental payment cap on the equipment is reached, with the exception of completing the rental
period for accessories whose first month rental began during the rental period for the
grandfathered equipment.