Medicare/Medicaid

906 South Monroe Street
Spokane, WA 99204

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Medicaid/Medicare and Insurance Billing

Covered Items

Product Coverage Criteria


	Medicaid/Medicare and Insurance Billing These guidelines are provided to give the physician and patient an expectation of coverage for Washington State Medicaid, Medicare and private insurance plans. The requirements for documentation generally are the same regardless of third party coverage. In order for an item to be covered a physician’s prescription and subsequent signature, is required. In addition a Certificate of Medical Neccesity (CMN) may also be required to be completed by the physician. Private pay insurance plans may also require a prior authorization before a product is delivered to a patient. You must review your individual policy to determine your exact coverage and coverage criteria. Our trained staff is happy to help our patients through this process. If you wish, you can email our Home Health Department by clicking in the link: Home Health Care You may download a Home Care Planning Guide to assist you in selecting the items that you need. Home Care Planning Guide

Covered Items

The following list provides a synopsis of covered items. These lists are not complete and are subject to change.


	Washington MEDICAID covered* items:


	Adjustable Canes Alternating Pressure Mattress Bath Equipment Bed Pans Blood Pressure Kits Braces of all types Commodes Crutches Eggcrate Mattresses Foam Cushions Gel Mattresses for Bed Gloves Heel/Elbow Protectors Hospital Beds


	Incontinence Products Jay Cushions Patient Lifts Platforms for Walkers w/Seat Quad Canes Replacement Parts Roho Cushions Trapeze Transfer Benches Tub Guards Urinals Versaframes Walkers Wheelchairs


	*Covered items subject to change


	MEDICARE Part B covered* items:


	Alternating Pressure Mattress Bedside Commodes Braces Canes Crutches Decubitus (wound) Care Products Gel Mattresses for Bed Glucose Monitors Heating Pads Hospital Beds


	Hydrocolators Parafin Bath Units Patient Lifts Traction Equipment Trapeze for Bed Roho Cushions Trapeze Walkers/Wheeled Walkers Wheelchairs, Manual/Electric Wheelchair Cushions


	*Covered items subject to change


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	Product Coverage Criteria

Clicking on the links will give you the coverage criteria for Medicare Part B.

You can use this guide to estimate the minimal expected coverage for a private insurance plan, however private insurance plans will differ. You must review your individual policy, or contact your benefits manager, to determine your exact coverage criteria.


			Bathroom Safety Commodes Beds and Accessories Hospital Beds - Fixed Height Hospital Beds - Variable Height Hospital Beds - Semi Electric Hospital Beds - Total Electric Patient Lifts Trapeze Bars Pressure Reducing Support Surfaces Pressure Reducing Surfaces - Group 1 Pressure Reducing Surfaces - Group 2 Walking Aids Canes and Crutches Walkers Wheelchairs Manual Wheelcchairs Motorized / Power Wheelchair Base Wheelchair Options and Accessories Power Operated Vehicles (Scooters or POV’s)

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