Durable Medical Equipment Chart

Durable Medical Equipment Chart

Durable Medical Equipment Chart

Refer to the chart below to find the equipment requested. Follow the line across to see what is required for a completed application. Incomplete applications are not considered until all requirements are met.

Durable Medical EquipmentPrescription Required?Documentation Required in Addition to PrescriptionNot Included with Requested DMEMeasurement
Bath BenchNoNoYes
Blood Pressure MonitorNoNoNo
CPAPYesSleep StudyMasks, hoses, and filtersNo
CommodeNoNoYes
Gait TrainerYesEvaluation Report from ATP/ OT/ PTYes
Hospital Bed
(electric/semi-electric)
YesNoMattressYes
Knee WalkerNoNoNo
NebulizerYesNoMedication and tubingNo
Patient LiftYesEvaluation Report from ATP/ OT/ PTSlingsYes
Quad CaneNoNoYes
Scooter (POV)YesEvaluation Report from ATP/ OT/ PTYes
Shower ChairNoNoYes
StanderYesEvaluation Report from ATP/ OT/ PTYes
Walker (and Rollators)YesNoYes
Wheelchair (manual)YesNoYes
Wheelchair (power)YesEvaluation Report from ATP/ OT/ PT
Column
Yes

If you are not currently working with a therapist, please contact the Device Reuse Program for potential sources to help with the evaluation report required for certain DME.

Oklahoma Device Reuse Program
3325 North Lincoln Boulevard, Suite B
Oklahoma City, OK  73105
Phone 405.523.4810 or 833.431.9706 (v/tty) / Fax 405-523-4811
Email: atreuse@okstate.edu