Medicare Part B covers durable medical equipment for millions of Americans — but the rules can be confusing. This guide explains how the DME benefit works and how to avoid coverage denials.
What Is Durable Medical Equipment?
DME is equipment that can withstand repeated use, is primarily for a medical purpose, is not useful to someone in good health, and is appropriate for home use. Examples include CPAP machines, oxygen equipment, wheelchairs, hospital beds, walkers, CGMs, and nebulizers.
How Medicare Part B Covers DME
Medicare Part B pays 80% of the Medicare-approved amount after you've met your Part B deductible ($257 in 2025). You're responsible for the remaining 20%. Medigap plans typically cover that 20%.
Capped Rentals vs. Outright Purchase
| Equipment Type | Payment Method |
|---|---|
| CPAP machines | 13-month capped rental, then ownership transfers |
| Wheelchairs | 13-month capped rental, then ownership transfers |
| Oxygen equipment | 36-month capped rental; Medicare pays for service after |
| Walkers, crutches | Direct purchase (no rental) |
| CGM sensors and supplies | Monthly purchase |
Four Requirements for DME Coverage
- Doctor's order — a physician must prescribe the equipment
- Medical necessity — documented clinical need in your medical record
- Medicare-enrolled supplier — supplier must be enrolled in Medicare
- Accredited supplier — supplier must be CMS-accredited for most categories
How to Avoid a Coverage Denial
- Always get a written prescription before ordering equipment
- Confirm your supplier is Medicare-enrolled AND accredited
- Ask if prior authorization is required for your specific equipment
- Keep copies of all paperwork — prescriptions, delivery receipts, compliance data