Specialized Medical Equipment and Supplies provides devices, controls, appliances or other items that support the person receiving the service to accomplish daily living activities or to communicate. This service also helps buy items necessary for life support and the supplies and equipment necessary for upkeep.
A person can buy equipment used for a longer period of time called durable equipment, such as wheelchairs or walkers, or disposable supplies called non-durable equipment, such as wipes or testing strips.
Specialized Medical Equipment and Supplies is available for people using the Level One Waiver. For people using the Individual Options Waiver, this service is billed as Adaptive and Assistive Equipment.
When to Apply this Service
The person’s service and support administrator, or SSA, will assess them for a need for Specialized Medical Equipment and Supplies. If there is a need, the SSA will include it in the person’s individual service plan.
Under the Level One Waiver, payment for specialized medical equipment and supplies that include environmental accessibility adaptations, home-delivered meals, personal emergency response systems, remote monitoring, remote monitoring equipment, and specialized medical equipment and supplies, alone or in combination, shall not exceed $7,500 within a three-year period.
Under the Individual Options Waiver, the maximum payment rate is $10,000.
Providing this Service
Agency and independent providers that have a Medicaid provider agreement and are DODD-certified can provide this service.
This service is provided on a one-on-one basis.
providers of specialized medical equipment and supplies must
- ensure proper installation if needed,
- provide training on using the equipment to the person, their family, service providers and others who may need it,
- properly maintain any rented equipment, and
- assume full liability for equipment improperly installed or maintained.
Training Requirements for this Service
After initial provider certification and annual training requirements, their are no additional training requirements needed to provide this service.
Billing and Payment Information
All services must be delivered as specified in the individual service plan and authorized in Payment Authorization for Waiver Services, known as PAWS, to be successfully submitted for payment through eMBS.
For people using the Individual Options Waiver, this service is billed as Adaptive and Assistive Equipment.
Rates and limits for Specialized Medical Equipment and Supplies are contained in the service rule's appendix.