405 IAC 5-19-5 Reimbursement for replacement durable medical equipment

Sec. 5. Subject to the criteria set forth in section 7 of this rule, Medicaid will pay for replacement of DME items. Notwithstanding such criteria, authorization for large DME, such as nonstandard or custom/special wheelchairs, hospital beds, and lifts, will not be given more than once every five (5) years per member unless there is a change in the member's medical needs, documented in writing by the requesting provider, significant enough to warrant a different type of equipment.