Pressure-reducing support surfaces

Pressure-reducing support surfaces

Part B covers pressure-reducing support surfaces as durable medical equipment (DME) that your doctor prescribes for use in your home.

 

Note
If you live in certain states, you may have to get prior approval [PDF, 185 KB] for 5 types of pressure-reducing support surfaces.

 

Your costs in Original Medicare

If your supplier accepts 

Assignment

 you pay 20% of the 

Medicare-approved amount

, and the Part B 

Deductible [glossary]

 applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:

  • You may need to rent the equipment.
  • You may need to buy the equipment.
  • You may be able to choose whether to rent or buy the equipment.

Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them. 

Make sure your doctors and DME suppliers are enrolled in Medicare. It’s important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare‑approved amount). If suppliers aren’t participating and don’t accept assignment, there’s no limit on the amount they can charge you. Medicare won’t pay claims for doctors or suppliers who aren’t enrolled in Medicare.

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

 

What it is

Pressure-reducing support surfaces include certain beds (including air-fluidized beds), mattresses, and mattress overlays.

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