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Disclaimer: Please read these terms carefully before using the policies below.
Listed on this page are the Jurisdiction A DME MAC LCDs regarding durable medical equipment, prosthetics, orthotics and supplies provided to Medicare beneficiaries. You may print and/or download these policies for your review and reference. Modification of these policies is strictly prohibited and all such modifications shall have no effect.
| Policy Title |
Policy Effective Date |
Policy Article Effective Date |
Date Posted |
File Type |
| Ankle-Foot/Knee-Ankle-Foot Orthosis (L11527) |
January 01, 2010 |
January 2010 |
January 2010 |
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| Automatic External Defibrillators (L13613) |
September 01, 2009 |
September 2009 |
June 2009 |
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| Canes and Crutches (L11496) |
July 01, 2007 |
July 2009 |
June 2009 |
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| Cervical Traction Devices (L15844) |
September 01, 2009 |
September 2009 |
June 2009 |
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| Cold Therapy (L5038) |
July 01, 2007 |
July 2009 |
June 2009 |
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| Commodes (L11497) |
September 01, 2009 |
September 2009 |
June 2009 |
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| Enteral Nutrition (L5041) |
January 01, 2008 |
July 2009 |
June 2009 |
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| Epoetin (L11463) |
September 01, 2009 |
September 2009 |
June 2009 |
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| External Breast Prostheses (L5043) |
July 01, 2007 |
July 2004 |
May 2007 |
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| External Infusion Pumps (L5044) |
January 01, 2009 |
January 2009 |
December 2008 |
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| Future LCD - External Infusion Pumps (L5044) |
April 01, 2010 |
January 2009 |
February 2010 |
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| Eye Prostheses (L11529) |
July 01, 2007 |
July 2009 |
June 2009 |
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| Facial Prostheses (L5046) |
January 01, 2010 |
January 2010 |
February 2010 |
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| Glucose Monitors (L11530) |
October 01, 2008 |
October 2008 |
December 2008 |
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| High Frequency Chest Wall Oscillation Devices (L12870) |
October 01, 2009 |
October 2008 |
July 2009 |
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| Home Dialysis Supplies and Equipment (L11498) |
September 01, 2009 |
September 2009 |
June 2009 |
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| Hospital Beds and Accessories (L5049) |
October 01, 2009 |
October 2009 |
July 2009 |
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| Immunosuppressive Drugs (L11531) |
July 01, 2008 |
July 2008 |
June 2008 |
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| Infrared Heating Pad Systems (L12873) |
July 01, 2007 |
August 2009 |
July 2009 |
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| Intrapulmonary Percussive Ventilation System (L5051) |
July 01, 2007 |
August 2009 |
July 2009 |
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| Intravenous Immune Globulin (L27260) |
January 01, 2009 |
January 2009 |
December 2008 |
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| Knee Orthoses (L27263) |
January 01, 2010 |
January 2010 |
January 2010 |
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| Lower Limb Prosthesis (L11464) |
January 01, 2009 |
October 2008 |
December 2008 |
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| Manual Wheelchair Bases (L11465) |
October 01, 2009 |
October 2009 |
July 2009 |
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| Mechanical In-exsufflation Devices (L12872) |
July 01, 2007 |
August 2009 |
July 2009 |
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| Nebulizers (L11499) |
January 01, 2010 |
January 2010 |
February 2010 |
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| Negative Pressure Wound Therapy Pumps (L11500) |
October 01, 2009 |
October 2009 |
July 2009 |
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| Oral Anticancer Drugs (L5057) |
April 01, 2008 |
October 2009 |
October 2009 |
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| Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) (L5058) |
December 01, 2009 |
January 2010 |
February 2010 |
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| Orthopedic Footwear (L11467) |
October 01, 2009 |
October 2009 |
July 2009 |
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| Osteogenesis Stimulators (L11501) |
August 01, 2009 |
August 2009 |
July 2009 |
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| Ostomy Supplies (L11502) |
January 01, 2010 |
January 2010 |
January 2010 |
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| Oxygen and Oxygen Equipment (L11468) |
January 01, 2009
(June Publication) |
January 2009 |
June 2009 |
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| Parenteral Nutrition (L5063) |
October 01, 2009 |
October 2009 |
July 2009 |
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| Patient Lifts (L5064) |
January 01, 2009 |
January 2009 |
December 2008 |
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| Pneumatic Compression Devices (L11503) |
January 01, 2009 |
January 2009 |
December 2008 |
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| Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L11528) |
January 01, 2010 |
March 2008
(September Publication) |
January 2010 |
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| Power Mobility Devices (L21271) |
October 01, 2009
(January 2010 Revision)
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January 2009 |
January 2010 |
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| Pressure Reducing Support Surfaces - Group 1 (L5067) |
December 01, 2009 |
December 2009 |
September 2009 |
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| Pressure Reducing Support Surfaces - Group 2 (L5068) |
January 01, 2009 |
January 2009 |
December 2008 |
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| Pressure Reducing Support Surfaces - Group 3 (L5069) |
January 01, 2009 |
January 2009 |
December 2008 |
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| Refractive Lenses (L11532) |
October 01, 2009 |
October 2009 |
July 2009 |
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| Respiratory Assist Devices (L11504) |
February 01, 2010 |
September 2009 |
January 2010 |
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| Seat Lift Mechanisms (L11533) |
June 01, 2007 |
September 2009 |
September 2009 |
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| Speech Generating Devices (L11534) |
December 01, 2009 |
December 2009 |
September 2009 |
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| Spinal Orthosis: TLSO and LSO (L11470) |
January 01, 2010 |
January 2010 |
February 2010 |
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| Suction Pumps (L11505) |
June 01, 2007 |
September 2009 |
September 2009 |
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| Surgical Dressings (L11471) |
January 01, 2010 |
January 2010 |
January 2010 |
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| Therapeutic Shoes for Persons with Diabetes (L11535) |
August 01, 2009 |
September 2009 |
September 2009 |
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| Tracheostomy Care Supplies (L11536) |
July 01, 2007 |
September 2009 |
September 2009 |
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| Transcutaneous Electrical Nerve Stimulators (TENS) (L11506) |
December 01, 2009 |
December 2009 |
September 2009 |
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| Urological Supplies (L5080) |
December 01, 2009 |
December 2009 |
September 2009 |
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| Walkers (L11472) |
December 01, 2009 |
December 2009 |
September 2009 |
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| Wheelchair Options and Accessories (L11473) |
January 01, 2009 |
January 2009
(March Publication) |
March 2009 |
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| Future LCD - Wheelchair Options and Accessories (L11473) |
April 01, 2010 |
January 2010 |
January 2010 |
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| Wheelchair Seating (L15845) |
December 01, 2009 |
January 2009 |
September 2009 |
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| Future LCD - Wheelchair Seating (L15845) |
April 01, 2010 |
January 2009 |
January 2010 |
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02/04/2010 |
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