Durable Medical Equipment Chart

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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 Equipment Prescription Required? Documentation Required in Addition to Prescription Not Included with Requested DME Measurement
Bath Bench No No   Yes
Blood Pressure Monitor No No   No
CPAP Yes Sleep Study Masks, hoses, and filters No
Commode No No   Yes
Gait Trainer Yes Evaluation Report from ATP/ OT/ PT   Yes
Hospital Bed
(electric / semi-electric)
Yes No Mattress Yes
Knee Walker No No   No
Nebulizer Yes No Medication and tubing No
Patient Lift Yes Evaluation Report from ATP/ OT/ PT Slings Yes
Quad Cane No No   Yes
Scooter (POV) Yes Evaluation Report from ATP/ OT/ PT   Yes
Shower Chair No No   Yes
Stander Yes Evaluation Report from ATP/ OT/ PT   Yes
Walker (and Rollators) Yes No   Yes
Wheelchair (manual) Yes No   Yes
Wheelchair (power) Yes Evaluation Report from ATP/ OT/ PT   Yes

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

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