Specialized Medical Equipment

(A) Conditions of Payment. Covered specialized medical equipment includes devices, controls, or appliances that enable a participant to increase their ability to perform daily living activities or to perceive, control, or communicate with the environment or to perceive or communicate with other people; medical equipment necessary to address physical conditions or participant functional limitations; and ancillary supplies and equipment necessary for the proper functioning of specialized items. This service may also include evaluation, customization, maintenance or repairs, temporary replacement, and training for the participant or caregiver in the use of the equipment. Specialized medical equipment must: (1) meet applicable standards of manufacture, design, and installation; and (2) have been examined or tested by Underwriters Laboratories (or other appropriate organization), and comply with Federal Communications Commission regulations, as appropriate. (B) Nonpayable Services. (1) Items that are not of direct medical or remedial benefit to a participant are not covered. (2) Specialized medical equipment must not be covered under 130 CMR 406.000: Pharmacy Services or 130 CMR 409.000: Durable Medical Equipment Services. (3) Items available to a participant through Medicare are not covered.