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In order for any Durable Medical Equipment dealer to provide services to a Medicaid beneficiary, they must be licensed pursuant to 907 KAR 1:479. The DME provide also:

  • Must be an active Medicare DME provider
  • Medicaid active provider, and
  • they must be enrolled with the Managed Care Organization (MCO) of any beneficiary they wish to treat. All services must be medically necessary.

​Durable Medical Equipment (DME) is equipment that withstands repeated use and is used primarily to serve a definite medical purpose. It is not generally useful to a person in the absence of an illness or injury. Medicaid covers DME such as wheelchairs, hospital beds, orthotic appliances (foot/leg braces), prosthetic devices (artificial limbs) etc., and disposable medical equipment ordered by an accepted prescriber that is medically necessary and suitable for use in the home.

For a list of what providers may perform services and any requirements to provide services, please refer to 907 KAR 1:479.

Some services may require a prior authorization in order to be covered. Just because a service is listed in the administrative regulation does not guarantee payment of the service.  Providers must follow the regulations and must follow requirements of the MCO for which they participate. 

Provider Contact Information

If you can't find the information you need or have additional questions, please direct your inquiries to:

Billing Questions - DXC - (800) 807-1232
Provider Questions - (855) 824-5615
Provider Enrollment or Recertification - (877) 838-5085 assistance - DXC - (800) 205-4696
Fraud and Abuse - (502) 564-2348
Pharmacy Questions - (800) 432-7005
Pharmacy Clinical Support Questions - (800) 477-3071
Pharmacy Prior Authorization - (800) 477-3071