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DME Provider Communications

Updated Continuous Glucose Monitoring Criteria - October 2, 2023 (PDF 163KB)

Prior Approval/Authorization Requirements for Medical Supplies reinstated on July 6, 2023 - June 27, 2023 (PDF 155KB)

Enteral Product Classification List 2023 - June 12, 2023 (PDF 184KB)

Information for Physicians and other Practitioners who prescribe Enteral Products for Medicaid Members, including Members affected by the Managed Care NYRx/ Fee for Service Transition - May 2, 2023 (PDF 152KB)

Information for DMEPOS Providers and Pharmacies dispensing Medical Supplies for Members affected by the Managed Care NYRx/ Fee for Service Benefit Transition beginning April 1, 2023 - April 17, 2023 (PDF 175KB)

Practitioners Ordering Incontinence Products - March 7, 2023 (PDF 82KB)

Correction - 2023 Coding Changes for Continuous Glucose Monitoring - January 13, 2023 (PDF 160KB)

Fee for Service DMEPOS Medical Supply Quantity Update - February 16, 2022 (PDF 50KB)

Updated Billing and Reimbursement Guidelines for HCPCS Code A4232 - September 17, 2021 (PDF 131KB)

Updated Billing and Reimbursement Guidelines for HCPCS Code E2402- Negative Pressure Wound Therapy - May 28, 2021 (PDF 172KB)

Webinars for the Interactive Voice Response System (IVR) for Medicaid Fee for Service (FFS) Enteral Product Authorizations - March 24, 2021 (PDF 140KB)

Reminder Uploading Documents to Prior Approvals Using ePACES - March 15, 2021 (PDF 139KB)

Webinars for the Interactive Voice Response System (IVR) for Medicaid Fee for Service (FFS) Enteral Product Authorizations - March 15, 2021 (PDF 140KB)

Updated Coverage Criteria for E0467- Home Ventilator, Multi-Function Respiratory Device - January 12, 2021 (PDF 150KB)

Change to the Dispensing Validation System (DVS) Authorization Time Frame - July 8, 2020 (PDF 19KB)

Updated Criteria for HCPCS Code A4670-Automatic Blood Pressure Monitor - June 3, 2020 (PDF 103KB)

Addition of New HCPCS Code E0467- Home Ventilator, Multi-Function Respiratory Device - April 9, 2020 (PDF 71KB)

Medicaid Changes to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Policy - March 31, 2020 (PDF 178KB)

Revised Speech Generating Device Guidelines Now Available - June 26, 2019 (PDF 106KB)

Changes for Approval of Continuous Glucose Monitoring and Insulin pumps for Individuals with Type 1 Diabetes - December 17, 2018 (PDF 344KB)

ENTERAL PRODUCT CLASSIFICATION LIST - August 3, 2018 (PDF 78KB)

Update for Reimbursement of Continuous Glucose Monitoring for Individuals with Type 1 Diabetes - May 16, 2018 (PDF 247KB)

Enteral Product Classification List - April 10, 2018 (PDF 88KB)

Reimbursement of Continuous Glucose Monitoring for Individuals with Type 1 Diabetes - October 26, 2017 (PDF 251KB)

ATTENTION Topical Oxygen Wound Therapy (TOWT) Continues to be Covered Until Further Notice - June 26, 2017 (PDF 48KB)

Medical Supply Quantity Update - June 14, 2017 (PDF 93KB)

Incontinence Supply Management Program - May 17, 2017 (PDF 11KB)

2017 DURABLE MEDICAL EQUIPMENT FEE SCHEDULE CHANGES - March 24, 2017 (PDF 105KB)

Incontinence Supply Management Program Fee Schedule Changes - March 6, 2017 (PDF 14KB)

Incontinence Supply Management Program Update - February 15, 2017 (PDF 8KB)

E0445 - Pulse Oximeter Coverage Criteria Update - February 14, 2017 (PDF 100KB)

E0627 and E0629 Seat Lift Mechanisms Update - December 28, 2016 (PDF 79KB)

2017 DME Procedure Code Changes - December 27, 2016 (PDF 19KB)

Incontinence Supply Management Program Update - November 11, 2016 (PDF 13KB)

Incontinence Supply Management Program Fee Schedule Changes - October 25, 2016 (PDF 14KB)

E0784 External Ambulatory Infusion Pump, Insulin - September 15, 2016 (PDF 32KB)

Incontinence Supply Management Program September 1, 2016 - August 17, 2016 (PDF 242KB)

2016 Durable Medical Equipment Fee Schedule Change - June 29, 2016 (PDF 10KB)

2016 DURABLE MEDICAL EQUIPMENT FEE SCHEDULE CHANGES - May 25, 2016 (PDF 70KB)

Pulse Oximeter Coverage Criteria Update - May 4, 2016 (PDF 33KB)

PA Required for Unlisted Wheeled Mobility Parts and Accessories - March 23, 2016 (PDF 170KB)

2016 DME PROCEDURE CODE CHANGES - December 30, 2015 (PDF 19KB)

NEW YORK STATE MEDICAID WHEELED MOBILITY EQUIPMENT, SEATING & POSITIONING COMPONENT GUIDELINES - October 8, 2015 (PDF 626KB)

ICD Changes Effective October 1, 2015 for Durable Medical Equipment Orthotics, Prosthetics and Medical Supplies, Hearing Aid, and Private Duty Nursing Prior Approval - September 29, 2015 (PDF 23KB)

Practitioners Ordering Incontinence Products - September 22, 2015 (PDF 51KB)

DMEPOS Providers Manual ICD-10 Update - September 22, 2015 (PDF 16KB)

Fee Schedule Change for DME - July 17, 2015 (PDF 11KB)

Enteral Supply List Updated May 1, 2015 - May 8, 2015 (PDF 87KB)

2015 Orthotics and Prosthetics / DME Procedure Code Changes - January 6, 2015 (PDF 18KB)

Wheeled Mobility Equipment Fee and Frequency Update - June 12, 2014 (PDF 144KB)

Ankle Foot Orthotic (AFOs) Allowed Frequency Update - June 12, 2014 (PDF 121KB)

Unlisted Wheeled Mobility Parts and Accessories - June 10, 2014 (PDF 61KB)

2014 Orthotics and Prosthetics/DME Procedure Code Changes - December 24, 2013 (PDF 12KB)

Medicaid Prescription Footwear and Stocking Benefit Update - December 18, 2013 (PDF 161KB)

ATTENTION: Correction to the September, 2013 Medicaid Update - October 17, 2013 (PDF 56KB)

Attention All Providers: MRT 3 Initiatives To Begin - Sept 16, 2013 (PDF 10KB)

Practitioners Ordering Incontinence Products (ICD-9 Quantity Tool) - June 28, 2013 (PDF 70KB)

Minimum Breast Pump Specifications Established for Medicaid Reimbursement Effective April 1, 2013 - March 22, 2013 (PDF 31KB)

Expandable Controller and Harness Coverage - March 14, 2013 (PDF 16KB)

Wheelchair Trays/Upper Extremity Support Surfaces - March 7, 2013 (PDF 20KB)

Notice to all Providers dispensing Orthotics and Prosthetics - March 7, 2013 (PDF 29KB)

NCCI Utilization Review Editing for DME Providers Notice - November 20, 2012 (PDF 20KB)

Attention DME Providers Affected by Hurricane Sandy - November 12, 2012 (PDF 60KB)

New York State Medicaid Speech Generating Device and Related Accessories Guidelines - October 8, 2012 (PDF 79KB)

Speech Generating Devices - October 8, 2012 (PDF 29KB)

Ostomy and External Urinary Supplies - October 1, 2012 (PDF 56KB)

SGD Webinar Presentation - September 18, 2012 (PDF 518KB)

Reminder for the Ordering and Billing of Incontinence Products - August 30, 2012 (PDF 25KB)

E2100 – Blood Glucose Monitor with Integrated Voice Synthesizer Update - May 15, 2012 (PDF 17KB)

Revisions to DME Procedure Code Section Rule 4 (Purchases) and Rule 6 (Rental Modifier) - March 7, 2012 (PDF 18KB)

Reminder DME Supply Coverage - December 29, 2011 (PDF 65KB)

2012 Orthotics and Prosthetics/DME Procedure Code Changes - December 23, 2011 (PDF 19KB)

Reminder DME Providers Pharmacists And Prescribers - December 6, 2011 (PDF 38KB)

Update on DME Rental Payment Accuracy and Utilization Review (UR) Edits - November 10, 2011 (PDF 30KB)

Reminder DME Providers Pharmacists And Prescribers - November 10, 2011 (PDF 57KB)

Prior Authorization for Enteral and Parenteral Pumps - November 1, 2011 (PDF 26KB)

Stockings Benefit Update - May 25, 2011(PDF 32KB)

Pricing Methodology Change for Orthopedic Footwear - May 10, 2011 (28KB)

Enteral Nutritional Formula Benefit Update - April 18, 2011 (PDF 20KB)

Prescription Footwear Benefit Update - April 5, 2011 (PDF 26KB)

Hospital Bed and Mattress Coding and Payment Update - March 30, 2011 (PDF 34KB)

2011 DME Code Authorization Update - March 30, 2011 (PDF 16KB)

NYS Medicaid Preferred Diabetic Supply Program Fact Sheet - February 3, 2011 (PDF 20KB)

Diabetic Supply Interested Parties Notification - February 3, 2011 (PDF 18KB)

2011 DME Procedure Code Changes - December 16, 2010 (PDF 16KB)

2011 DME Supply Procedure Code Changes - December 16, 2010 (PDF 12KB)

2011 DME Orthotics And Prosthetics Procedure Code Changes - December 16, 2010 (PDF 16KB)

Medicaid Managed Care and Family Health Plus Coverage of Hearing Aid and Cochlear Implant Device Batteries - September 20, 2010 (PDF 18KB)

Enhancements To Interactive Voice Response Enteral Formula Telephone Prior Authorization - August 17, 2010 (PDF 66KB)

E2619- Replacement Seat/Back Cushion Cover Update - July 1, 2010 (PDF 13KB)

E0316 - Safety Enclosure Frame/Canopy Update - June 21, 2010 (PDF 23KB)

Update on Durable Medical Equipment Utilization Review (UR) Edits - April 19, 2010 (PDF 26KB)

Combination Disposable-Reusable Underpads - December 28, 2009 (PDF 52KB)

2010 Supply Procedure Code Changes - December 28, 2009 (PDF 18KB)

2010 DME Procedure Code Changes - December 28, 2009 (PDF 20KB)

2010 Orthotics and Prosthetics Procedure Code Changes - December 28, 2009 (PDF 40KB)

Oxygen Codes Update - December 3, 2009 (PDF 20KB)

A4481-Supply Item Change - November 2, 2009 (PDF 416KB)

E0641-Standing Frame, Multi-position Update - October 16, 2009 (PDF 732KB)

NYS Medicaid Preferred Diabetic Supply Program (PDSP) Durable Medical Equipment (DME) Providers Billing Information Update - October 5, 2009 (PDF 45KB)

NYS Medicaid Preferred Diabetic Supply Program DME Billing Information - September 14, 2009 (PDF 603KB)

Diagnosis Code Required for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fiscal Orders - September 8, 2009 (PDF 68KB)

Enteral Product Classification List - August 24, 2009 (PDF 572KB)

New Modifier Available August 6, 2009 (PDF 10KB)

Diaper Liner Claims Edit Update June 15, 2009 (PDF 21KB)

Disposable Diapers and Liners for Incontinence May 6, 2009 (PDF 20k)

Enteral Formula Prior Authorization Dispenser Worksheet - April 13, 2009 (PDF 16KB)

Wheelchair and Seating Assessment Guide - April 9, 2009 (PDF 818KB)

Checking Beneficiary Eligibility - April 2, 2009 (PDF 22KB)

Frequency Guidelines for Blood Glucose Testing - March 26, 2009 (PDF 76KB)

2009 Orthotics and Prosthetics Procedure Code Changes - December 31, 2008 (PDF 38KB)

Automatic Blood Pressure Machines - December 31, 2008 (PDF 79KB)

Prior Approval Process for Enrollees Eligible for Both Medicare and Medicaid - December 29, 2008 (PDF 62KB)

Oxygen Concentrator Update - December 22, 2008 (PDF 65KB)

Enteral Product Classification List - October 30, 2008 (PDF 121KB)

DME Fee Schedule Changes - October 20, 2008 (PDF 55KB)

New York State Medicaid Wheeled Mobility Equipment, Seating & Positioning Component Guidelines - October 16, 2008 (PDF 223KB)

DME Repair Update October 1, 2008 - October 9, 2008 (PDF 101KB)

Infant Apnea Monitor Changes - September 4, 2008 (PDF 69KB)

MRA Changes For_DME - August 25, 2008 (PDF 52KB)

Bath Chairs and Tub and Shower Stand No Longer Subject to Medical Review - July 21, 2008 (PDF 17KB)

MRA Changes For_DME - July 11, 2008 (PDF 47KB)

Change_For_DME - July 11, 2008 (PDF 46KB)

New Codes for Hospital Bed Equipment - July 2, 2008 (PDF 70KB)

New York State Medicaid Hospital Bed Guidelines - July 2, 2008 (PDF 94KB)

Updated Fiscal Order Requirements - June 27, 2008 (PDF 73KB)

Enteral Product Classification List - June 25, 2008 (PDF 120KB)

Osteogenesis Stimulator Worksheet - June 6, 2008 (PDF 80KB)

New York State Medicaid Topical Oxygen Wound Therapy Guidelines - April 2, 2008 (PDF 30KB)

New York State Medicaid Wearable Automatic External Defibrillator Guidelines.pdf - April 2, 2008 (PDF 28KB)

Fee Schedule Change for DME - March 7, 2008 (PDF 15KB)

Payment Changes for Bone Growth Stimulators - January 11, 2008 (PDF 18KB)

New York State Medicaid Wheeled Mobility Equipment, Seating & Positioning Component Guidelines - January 9, 2008 (PDF 100KB)

2008 Orthotics and Prosthetics Labor Changes - January 9, 2008 (PDF 11KB)

DME Supply Updates - December 28, 2007 (PDF 42KB)

Durable Medical Equipment Updates - December 28, 2007 (PDF 37KB)

2008 Orthotics and Prosthetics Procedure Code Changes - Dec. 21, 2007 (PDF 16KB)

Durable Medical Equipment Updates - October 05, 2007 (PDF 18KB)

Silhouette Seat Cushion and Back - August 17, 2007 (PDF 23KB)

Wheeled Mobility Evaluation Template 1 (MS Word format) - August 17, 2007 (DOC 348KB)

Prior Approval for Dually Eligible - August 08, 2007 (PDF 67KB)

Wheeled Mobility Equipment Guidelines - July 06, 2007 (PDF 74KB)

Wheeled Mobility Evaluation Template 1 - July 6, 2007 (PDF 68KB)

Revisions to Wheeled Mobility Equipment Guidelines - June 13, 2007 (PDF 10KB)

DVS Authorization for Manual Wheelchairs and Certain Wheelchair Accessories - June 1, 2007 (PDF 12KB)

Fee Changes for Wheelchair Cushions and Battery Charger - May 1, 2007 (PDF 18KB)

2007 DME Procedure Code Changes - Jan. 3, 2007 (PDF 13KB)

2007 Supply Procedure Code Change - Jan. 3, 2007 (PDF 9KB)

2007 Orthotics and Prosthetics Procedure Code Changes - Jan. 3, 2007 (PDF 16KB)

Wheeled Mobility Seating and Positioning Guidelines - 10/25/06 (PDF 75KB)

Enteral Product Classification List - 5/11/06 (PDF 43KB)

Footwear 1-1-2006 Changes - Updated - Feb. 15 2006 (PDF 32KB)

Two new processes affecting Durable Medical Equipment providers effective on January 23, 2006 - Feb. 06 2006 (PDF 213 KB)

Orthotics & Prosthetics Code Changes - Jan. 01 2006
(PDF 37KB)

Footwear Code Changes - Jan. 01 2006 (PDF 21 KB)

DME Code Changes - Jan. 01 2006 (PDF 26KB)

DME Provider Letter - Oct. 28 2005 (PDF 93 KB)

Enteral Formula Dispenser Worksheet - October 2005
(PDF 21KB)

DME Provider Letter - Mar. 16 2005 (PDF 103 KB)

DME Provider Letter - Jan. 14 2005 (PDF 58 KB)