Durable Medical Equipment (DME)

DME providers must be licensed annually by the Alabama Board of Home Medical Equipment Services (HME). For more information regarding how to become a licensed HME provider, visit  www.homemed.alabama.gov and click on the forms link.For questions about Durable Medical Equipment (DME):  Email DME Program Phone: 334-242-5050

ATTENTION: All DME Providers: A new feature has been added to the provider web portal. DME providers will have the option to view all DME PAs for a recipient, even those requested by another provider. Please review the provider web portal User Manual for instructions. Contact the Gainwell Technologies assistance center at (800) 456-1242 or (334) 215-0111.

• ALERT regarding DME CURES Act Fee Schedule - 4/20/18
• ALERT on DME Program Changes - 4/29/14
• Clarification to ALERT on Reversal of Payment Reductions - 9/18/19
  • Clarifies processing of manually-priced items  Click for ALERT
• Follow-Up Q&As: CMS Face-to-Face Requirement for Certain DME Equipment - 10/19/18

• DME-POP Fee Schedule
• DME Manually-Priced Fee Schedule
• DME EPSDT Referral Fee Schedule
• 2022 DME CURES Act Fee Schedule

• Provider Manual - Chapter 14 - DME
• Provider Manual - Appendix P - DME Procedure Codes and Modifiers
• Administrative Code - Chapter 13 - Supplies, Appliances, and DME  

• PowerPoint Training for Incontinence Supplies - 1/6/22
• Continuous Glucose Monitor Policy Information
• Diabetic Supply Coverage Policy - Effective 3/1/12
• DME Provider Reimbursement Adjustments Review - 9/1/20
• Checklist for Durable Medical Equipment - Information on denials, reasons for recoupments, where to find information in the Medicaid Provider Billing Manual, free tools and contacts  for providers to use in preventing fraud and abuse.

• Form 384 - Wheelchair/ Seating Evaluation
• Form 386 - Wheelchair Modification
• Form 360 - Oxygen Therapy - Updated 11/9/20
• Alabama Medicaid Dossier Submission Form/ Packet

• DME Providers - Updated 8/26/21
• Phototherapy Providers - Updated 11/1/19
• DME Wheelchair Repair Providers - 10/24/13
• Hospitals Participating in PT Evaluations for Motorized Wheelchairs - 5/9/14

• Checklists
Important COVID-19 Updates for DME Providers
In response to the Coronavirus Disease 2019 (COVID-19), the Alabama Medicaid Agency has compiled a summary of changes and allowances made by the Agency as they apply to DME providers. Medicaid has extended all expiration dates below related to the Coronavirus (COVID-19) emergency.
• See all ALERTS here:https://medicaid.alabama.gov/alerts.aspx
• Medicaid COVID-19 updates here:          https://medicaid.alabama.gov/news_detail.aspx?ID=13729
• Updated signature requirements during the state of emergency, effective 3/16/20
  • See ALERT here:         https://medicaid.alabama.gov/alert_detail.aspx?ID=13755
• Existing Prior Authorizations can temporarily be extended for 30 days, effective 3/16/20
• New Prior Authorizations will still be processed through normal means, but with the following temporary modifications during the state of emergency, effective 3/16/20:
  • Face to Face evaluation is not required; telemedicine is allowed
  • Prescription orders is not considered outdated if 90 days past date written
  • EPSDT screening/referrals not needed for prior authorization
DME providers, During the state of emergency, the Alabama Medicaid Agency hopes to provide additional options to submit a prior authorization request (or renewal request).  Please see below.   Options for Submitting Prior Authorization (PA) requests to Kepro due to COVID 19 State of Emergency
• If faxing via Form 471:
• Single Request - Only complete the Supplier Information section and then add the PA number and a brief comment (i.e. PA extension).
• Multiple Requests-Only complete the Supplier Information section and then attach a list of the PAs and a brief comment (i.e. PA extension).
• Requests may be faxed to 833-536-2134 or 833-536-2136 (the fax number is located on the Form 471, bottom of page). 
• You may call a Kepro reviewer directly regarding your PA request(s) at 800-426-7259 or 800-472-2902. 
• Please reference the provider Portal for PA extension updates.
• Please feel free to contact Kepro as needed for any questions at 800-426-7259 or 800-472-2902.