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Durable Medical Equipment

Beginning Aug. 1, 2020, medical supplies, equipment and appliances, formerly referred to in policy as DMEPOS, were moved to the home health portion of the policy. This change allows some new services to be covered when medical necessity guidelines are met. Some of the notable changes include:

  • Nebulizers.
  • C-paps.
  • Sleep studies.
  • Bath and toileting equipment (e.g. commode chair, bath and shower chair, transfer bench).
  • Enteral (tube fed) formulas and supplies.
  • Incontinence supplies. 
    • Please note, incontinence supplies for member’s ages 0-20 must be provided by People First Industries.

This change does not include prosthetics and orthotics, as no changes were made to those services. Although there is not a published list of codes covered by age, you may review specific codes in the secure provider portal fee schedule.

Prior Authorization Guidelines

Durable Medical Equipment

Incontinence Supplies

Vision

Accreditation

Coding

Complex Rehab Technology

For DME Suppliers currently contracted with SoonerCare seeking to obtain CRT Provider Specialty please read over the CRT packet then submit the completed addendum along with the required supporting documentation via fax to 405-530-3261.

 

CRT Packet.pdf

Frequently Asked Questions

  • FAQ - Wheeled Mobility
  • FAQ - Repair items that do not require Prior Authorization

 

Pricing

Resources

 

Utilization Worksheets