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Attention providers: Medicaid only covers medical supplies, equipment ordered by a physician

In accordance with 42 C.F.R. § 440.70, only medical supplies, equipment and appliances ordered by a physician are covered and reimbursed under the Medicaid program.  As a result of discussions with the Centers for Medicare and Medicaid Services (CMS) regarding proposed State Plan Amendment (SPA) 17-0001 Home Health Services, the Division of Medicaid was instructed by CMS to remove the current SPA language which allows non-physician practitioners to order medical supplies, equipment and appliances.  Therefore, effective September 1, 2018, the Division of Medicaid will no longer cover medical supplies, equipment and appliances ordered by non-physician practitioners.  Durable Medical Equipment (DME) providers are required to specify the ordering physician’s National Provider Identifier (NPI) on any claim for payment to maintain compliance with C.F.R. § 455.440.

For more information regarding the ordering requirements of medical supplies, equipment and appliances, please contact the Office of Medical Services (601) 359-6150.