Durable Medical Equipment (DME) Required Documentation

DME Requirements

Durable Medical Equipment (DME) providers must disclose the following records to the Texas Health and Human Services Commission (HHSC) or its designee on request.  These records and claims must be retained for a minimum of five years from the date of service (DOS) or until the audit questions, appeals, hearings, investigations, or court cases are resolved.  Use of these service is subject to retrospective review.

Required DME Documents

Durable medical equipment providers must retain the following documents:

• Home Health Services (Title XIX) DME/ Medical Supplies Physician Order forms 
  • Home Health Services (Title XIX) DME/Medical Supplies Physician Order Forms
  • Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Forms
  • Ordering Physicians must maintain copies of the completed, originally signed and dated forms in their records.
• Delivery Slips
  • Providers must retain individual delivery slips or invoices for each DOS that shows the date of delivery of all supplies provided to the client.
  • Documentation of delivery must include one of the following:
    • Delivery slip or corresponding invoice signed and dated by client or caregiver.
    • A dated carrier tracking document with shipping date and delivery date must be printed from the carrier’s website as confirmation. The dated carrier tracking document must be attached.
  • The following must be included in the dated delivery slip:
    • Client’s full name
    • Address where supplies were delivered
    • Itemized list of goods (includes descriptions and numberical quantities)
    • Corresponding tracking number from carrier.

• Claims Submission
  • All claims submitted for medical supplies must include the same quantities or units that are documented on the delivery slip or corresponding invoice and on the Home Health Services (Title XIX) forms.
  • The number of units by which each product is measured must be included.
  • Must be one dated delivery slip or invoice for each claim submitted for each client.
  • All claims submitted for medical supplies must reflect either one business day before or after the date of service as documented on the delivery slip or corresponding invoice and the same information covered by the Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form.
  • The DME Certification and Receipt Form is still required for all equipment delivered.

HHSC and Texas Medicaid and Healthcare Partnership (TMHP) reserves the right to request the signed and dated Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form or Addendum to Home Health Services (Title XIX) DME Form at any time.

Note: Client eligibility can change monthly.

Resources

Please reference the Texas Medicaid Provider Procedures Manual -Volume 2-DME.

Questions

Providers, for questions or additional information, please:

• Contact your BCBSTX Medicaid Provider Network team at 1-855-212-1615 or
• Submit via email Texas Medicaid Network Department