Join our Newsletter    Events    Shop    Contact Us
advocates-for-medically-fragile-kids-nc-logo
Search
Close this search box.
Welcome to our new website! If you have any suggestions, please email info@fragilekidsnc.org

Home  •  Waiver & Medicaid Services  •  Medicaid  •  Coverage for Equipment, Supplies & Therapies

Medicaid for Waiver
& Non-Waiver Recipients

growing-plant-showing-growth-and-life

Coverage for Equipment, Supplies & Therapies

Click a title below to learn about the subject.

Equipment

Medicaid State Plan covers lots of different types of equipment through Durable Medical Equipment (DME) companies, including specialized beds, wheelchairs, activity chairs, lifts, gait trainers, standers, bath and toilet aids, as well as communication devices. Respiratory equipment, such as oxygen, respiratory assist devices, nebulizers, apnea monitors, percussors, pulse oximeters, suction machines, airway clearance devices, and cough-assist devices, are also items that can be covered through a DME company. Nursing equipment such as a wound vac, insulin pump, continuous glucose monitor (CGM), bilirubin light therapy, farrell valve gastric pressure relief, and oral/enteral formula can also be covered and may be obtained through a pharmacy, DME company, or nursing agency. Most of these supplies and equipment require a letter of medical necessity written and signed by a physician, physician assistant, or nurse practitioner, along with an accompanying CMN/PA form found in our Quick Links section. NC Medicaid also requires a face-to-face visit with the prescribing provider where the requested equipment or item is specifically addressed within 6 months of the request submission date in the provider’s visit note.

In addition to all the supplies associated with the above equipment, the Medicaid State Plan also covers incontinence supplies (i.e., diapers/pull-ups) starting once a child turns 3 years old.

Therapies such as physical therapy, occupational therapy, speech language therapy, audiology therapy, and respiratory therapy are all covered services under the Medicaid State Plan. For children, it is not a requirement that progress must continue to be made for the therapy to continue. For example, in some cases, the therapy being requested is preventing further deterioration and should be approved.