Durable Medical Equipment (DME)

Provider types: 65 and 90

Pharmacy providers will be permitted to continue billing insulin syringes, blood glucose test strips/meters through the pharmacy POS system until December 31, 2005. Providers that choose to use the DME format can do so starting August 1, 2005 or thereafter.

Nutritional supplement prior authorization requests approved by Medicaid Pharmacy Services prior to August 1, 2005 will continue to be paid through the pharmacy system until they expire. All requests for nutritional supplements after August 1, 2005 must be obtained through DME.

Effective August 1, 2005, Medicaid Pharmacy Services will no longer reimburse for the following items: Nutritional Supplements (Enteral Feeding Formulas), Peak Flow Meters, Spacers, Insulin Syringes, Blood Glucose Meters and Blood Glucose Strips.

Effective July 1, 2005, Medicaid Pharmacy Services will no longer reimburse for the following items: Heparin Lock Flush Syringes, Normal Saline Flush Syringes, Urine Ketone Test Strips.

Coverage of these products is being moved to Medicaid’s Durable Medical Equipment Program (DME) and must be billed using CMS form 1500 with HCPCS codes.

Public Meeting Information - Disposable Incontinence Medical Supply Program

Presentation for Public Meetings Concerning the Disposable Incontinence Medical Supply Program [93KB PDF]

RFP 0606 – Disposable Incontinence Medical Supply Program - Withdrawn May 16, 2006

Durable Medical Equipment and Medical Supply Services Authorization Request for Enteral Formula [51KB] Prior Authorization is currently suspended

Policy Brief re: Enteral Nutrition Products [45KB PDF] As of 7/27/05

Enteral Nutrition Products Category Lists [47KB PDF]

Insulin Supplies List [7KB PDF]

For the Durable Medicaid Equipment (DME) handbook, visit the our fiscal agent website, http://floridamedicaid.acs-inc.com/index.jsp.