by Jared Staheli
June 18th, 2015
For certain items or services billed to the DME Regional Carrier (DMERC), the supplier must receive a signed Certificate of Medical Necessity (CMN) from the treating physician. CMNs are not required for the same items when billed by HHAs to RHHIs. Instead, the items must be included in the physician's signed orders on the home health plan of care. See the Medicare Program Integrity Manual, Chapter 6.
The FI will inform other providers (see §01 for definition pf provider) of documentation requirements.
Contractors may ask for supporting documentation beyond a CMN.
Refer to the local DMERC Web site described in §10 for downloadable copies of CMN forms.
See the Medicare Program Integrity Manual, Chapter 5, for specific Medicare policies and instructions on the following topics:
• Requirements for supplier retention of original CMNs
• CMN formats, paper and electronic
• List of currently approved CMNs and items requiring CMNs
• Supplier requirements for submitting CMNs
• Requirements for CMNs to also serve as a physician's order
• Civil monetary penalties for violation of CMN requirements
• Supplier requirements for completing portions of CMNs
• Physician requirements for completing portions of CMNs