Medicare DME Coverage: What Equipment Is Covered and How to Get It

What Medicare Considers Durable Medical Equipment

Medicare Part B pays for durable medical equipment (DME), but only if the item fits a specific five-part definition set by the Centers for Medicare and Medicaid Services (CMS). Every checkbox has to be met, not just some.

To qualify as DME in 2026, the item must:

• Be durable and able to withstand repeated use
• Serve a medical purpose (not just comfort or convenience)
• Not be useful to someone without an illness or injury
• Be appropriate for use in the home
• Have an expected life of at least three years (for items classified as DME after January 1, 2012)

A doctor or authorized clinician enrolled in Medicare must also order the equipment and document that it is medically necessary. And you must get the item from a Medicare-enrolled supplier with an active Medicare supplier number. For a broader look at what Part B pays for beyond equipment, see our Part A and Part B guide.

What Equipment Medicare Covers (and What It Doesn't)

Medicare Part B covers a long list of common DME items when they are medically necessary and used in the home. It also excludes a surprising number of items people assume are covered, particularly bathroom safety gear and disposable supplies.

Commonly Covered DME

• Manual and power wheelchairs, scooters
• Walkers, rollators, canes (but not white canes for the blind), and crutches
• Hospital beds and pressure-reducing mattresses
• CPAP and BiPAP machines and accessories
• Oxygen equipment, tanks, and related supplies
• Nebulizers and nebulizer medication
• Blood glucose monitors, test strips, lancets, and insulin pumps
• Patient lifts and commode chairs (if you're confined to your bedroom)
• Infusion pumps and IV poles for home infusion therapy
• Suction pumps, traction equipment, and continuous passive motion (CPM) machines

What Medicare Generally Won't Cover

Items that are for comfort, convenience, or home modification usually aren't covered, even when a doctor recommends them.

Most bathroom safety equipment (grab bars, shower chairs, raised toilet seats) is considered home modification rather than medical equipment. Air conditioners, elevators, and widened doorways fall in the same bucket, even when a physician says they help a patient's condition. For a wider view of what Original Medicare skips, read our breakdown of what Medicare doesn't cover.

How Much You'll Pay for DME in 2026

Under Original Medicare, your out-of-pocket cost for covered DME follows the standard Part B formula. In 2026, that means you first meet the annual Part B deductible of $283 (up from $257 in 2025). After that, Medicare pays 80% of the Medicare-approved amount and you pay the remaining 20% coinsurance, as long as your supplier accepts assignment.

Example: A $1,200 Wheelchair

That 20% has no annual cap under Original Medicare, so a power wheelchair or long-term oxygen rental can add up fast.

How Medigap Fills the Gap

A Medicare Supplement (Medigap) policy is designed to cover exactly this kind of cost. Every standardized Medigap plan pays the Part B coinsurance, which is the 20% you'd otherwise owe on DME. Plan G and Plan N both cover the DME coinsurance in full, though only Plan G pays the Part B deductible for people who became Medicare-eligible before 2020. Plans K and L cover 50% and 75% of the DME coinsurance respectively, with annual out-of-pocket limits.

Medicare-Approved Suppliers and Competitive Bidding

Medicare only pays for DME from suppliers enrolled in Medicare, and for many items, only from suppliers that accept assignment. "Accepting assignment" means the supplier agrees to Medicare's approved amount as full payment, so you can't be balance-billed above the 20% coinsurance.

The Competitive Bidding Program

Medicare's DMEPOS Competitive Bidding Program sets prices for certain equipment categories by having suppliers submit bids. Contract suppliers agree to a single payment amount for covered items in defined areas. Under updated CMS rules, the payment is now calculated at the 75th percentile of winning bids and adjusted annually using the Consumer Price Index.

The next round of competitive bidding is expected to award contracts in 2027, with pricing taking effect January 1, 2028. CMS is also introducing a nationwide Remote Item Delivery (RID) model for mail-order categories, meaning contract suppliers must be able to furnish those items to beneficiaries anywhere in the U.S. Certain high-cost categories like oxygen, CPAP, and standard power wheelchairs are not currently on the bidding list.

Finding a Supplier That Accepts Assignment

The easiest way to find a compliant supplier is Medicare's own directory:

1. Go to Medicare.gov/medical-equipment-suppliers
2. Enter your ZIP code
3. Select the equipment category you need
4. Filter results by "Medicare-approved payment" to see suppliers that accept assignment
5. Call the supplier and confirm three things: they're currently enrolled in Medicare, they accept assignment on your specific item, and they'll handle prior authorization if it applies

Rental vs Purchase Rules

Medicare doesn't let you decide whether to rent or buy your DME. That call is set by Medicare's classification of each item, and it can materially change your out-of-pocket cost.

• Capped rental items. Wheelchairs, hospital beds, nebulizers, and CPAP machines are usually rented. Medicare pays the supplier monthly for up to 13 months, after which you own the equipment.
• Inexpensive/routine purchase items. Canes, walkers, crutches, commode chairs, and blood glucose monitors are typically bought outright.
• Oxygen equipment. Rented on a 36-month schedule. After 36 months, the supplier must continue providing the equipment and any needed maintenance for up to 5 years, but Medicare stops paying rental.
• Frequently serviced items. Ventilators and some infusion pumps are rented for as long as they're medically necessary.

Prior Authorization and Appealing a DME Denial

Some higher-cost DME items require prior authorization before Medicare will pay. As of April 2026, the Required Prior Authorization List includes 74 HCPCS codes covering categories like power mobility devices (Group 3 and above power wheelchairs), certain lower-limb prosthetics, pressure-reducing support surfaces, spinal and knee orthoses, and pneumatic compression devices. Seven new codes were added on April 13, 2026, including several orthoses and pneumatic compression devices.

Your supplier is responsible for submitting the prior authorization request, but you can (and should) confirm it was approved before the equipment is delivered.

If Medicare Denies Your DME Claim

If your claim is denied after billing, Original Medicare gives you a formal five-level appeals process. Here's how it starts:

1. Get the reason in writing. Ask the supplier for the exact denial reason and the HCPCS code that was billed.
2. File a redetermination. Request a redetermination from the Medicare Administrative Contractor (MAC) within 120 days of the denial. Use the address on your Medicare Summary Notice.
3. Gather documentation. Include your doctor's written order, notes from the face-to-face exam (if required), medical necessity documentation, and any prior authorization approval.
4. Escalate if denied again. If redetermination is denied, request a reconsideration by a Qualified Independent Contractor, then a hearing before an Administrative Law Judge, then the Medicare Appeals Council, and finally federal district court.

Frequently Asked Questions

Does Medicare cover a CPAP machine?

Yes. Medicare Part B covers CPAP machines as capped rental DME when prescribed for obstructive sleep apnea documented by a sleep study. You'll pay 20% coinsurance on the rental after meeting the Part B deductible. After a 12-week trial period, Medicare requires documentation that you're actually using the machine (typically at least 4 hours per night on 70% of nights) to continue coverage.

Does Medicare pay for a wheelchair or power scooter?

Medicare Part B covers manual wheelchairs, power wheelchairs, and scooters when medically necessary for use in the home. Your doctor must conduct a face-to-face exam and write an order documenting why the equipment is needed. Power wheelchairs in Group 3 and above require prior authorization, and Medicare pays 80% of the approved amount after your $283 deductible in 2026.

Are grab bars and shower chairs covered by Medicare?

No. Grab bars, shower chairs, raised toilet seats, and most other bathroom safety equipment are considered home modifications or comfort items, not DME. Some Medicare Advantage plans include a small annual allowance for these items as a supplemental benefit, but Original Medicare and Medigap will not pay for them.

How does Medigap help with DME costs?

Every standardized Medigap plan pays at least part of the 20% Part B coinsurance you'd otherwise owe on covered DME. Plans G and N pay the coinsurance in full, while Plans K and L pay 50% and 75% respectively (with annual out-of-pocket caps). Medigap does not cover items Medicare denies, so it only helps when the underlying claim is approved.

What if my DME supplier doesn't accept assignment?

If your supplier doesn't accept assignment, they can charge more than the Medicare-approved amount and you'd be responsible for the difference on top of your 20% coinsurance. Some suppliers may also require you to pay the full cost upfront and file your own claim with Medicare. The safer route is to use the Medicare Supplier Directory to find a supplier that accepts assignment on your specific item.