Chapter 1: Accessibility and Assistive Technology
Section 3: Assistive Technology Suppliers and Catalogs
Subsection A: Medicare Beneficiaries - Durable Medical Equipment Suppliers
Medicare is the health benefit available to persons receiving Social Security Disability Insurance (SSDI) or Social Security retirement and to some other connected individuals.
Medicare generally covers Durable Medical Equipment (DME) that:
- Can stand repeated use;
- Is primarily and customarily used to serve a medical purpose;
- Is generally not useful to a person in absence of illness or injury; and
- Is appropriate for use in the home.
Medicare typically pays 80% of the Medicare allowable charge for an item or service. The patient may have to pay a deductible and co-payment. A doctor's prescription and in some cases a Certificate of Medical Necessity are required for Medicare payment for medical equipment.
Palmetto Government Benefits Administration handles Durable Medical Equipment (DME) claims for Medicare in this region. Questions on Medicare DME coverage can be directed to 800-213-5452.
Select a state supplier list at this site. The suppliers listed are those who have agreed to accept what Medicare pays and to charge the patient no more than the Medicare allowable charge. The beneficiary still must pay the normal Medicare co-payment for medical equipment, but "participating" suppliers will not charge more than that.
Note: Medicare beneficiaries can also use "non-participating" Durable Medical Equipment (DME) suppliers who have Medicare supplier numbers. These suppliers have not agreed to charge no more than the Medicare allowable charge. For a list of both "participating" and "non-participating" DME suppliers go to the following link: https://www.medicare.gov/what-medicare-covers/part-b/competitive-bidding....
Medicare and You, the Medicare Handbook
To report Medicare fraud, call 1-800-MEDICARE or follow this link to the Medicare Fraud webpage, https://www.medicare.gov/forms-help-and-resources/report-fraud-and-abuse....
Durable Medical Equipment (DME) Center
Palmetto Government Benefits Administration handles Durable Medical Equipment (DME) claims for Medicare in this region. Questions on Medicare DME coverage can be directed to 800-213-5452. For more information on Durable Medical Equipment follow this link, https://www.medicare.gov/what-medicare-covers/part-b/durable-medical-equ....
The Dallas Regional Office (Region 6) should be your initial point of contact on any Medicare, Medicaid, or State Child Health Insurance Program (SCHIP). For general inquiries, use the telephone number listed below. For more specific issues, review the Contact List under the Downloads section at the bottom of this page.
CMS - Region 6
1301 Young St., Ste. 714
Dallas, TX 75202
The National Supplier Clearinghouse is the single organizational entity responsible for issuing or revoking Medicare supplier billing privileges for suppliers of Durable Medical Equipment, Orthotics and Supplies (DMEPOS).
Palmetto Government Benefits Administration Durable Medical Equipment Regional Carrier (DMERC) Region C
Palmetto GBA handles Medicare claims for durable medical equipment, including orthotic and prosthetic devices for Oklahoma and several other states.
Contact info: https://www.cgsmedicare.com/jc/cs/contactinfo.html