This policy applies to MVP NY Medicaid Plans and their coverage for Medical Devices and Supplies.

The following examples are not all inclusive, that apply to this policy:

1. Foot Care products: insoles, massagers, arch supports
2. Pill Splitters
3. Body weight scales
4. Pulse Oximeters
5. Thermometer’s (only oral, rectal and basal are covered)
6. Wheelchair products
7. Medical fridges
8. Commodes
9. Transfer benches
10. Safety rails (bed, wall, bath)
11. Fetal dopplers
12. Bath/shower/toilet sears
13. Sharp’s containers
14. Ear Plugs
15. Nasal dilator strips
16. Cushions
17. Decompression belts
18. Reaches
19. Travel Coolers etc

MVP is aligning with NY Medicaid Fee for Services DME coverage. Devices or supplies that are NOT COVERED under FFS Medicaid “Pharmacy Fee Schedule” will continue to not be covered. Applicable DME Products should be billed under the member’s DME Benefit.

For complete list of NY MEDICAID DME COVERED and NON-COVERED Products, please click here.

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