Hospital Beds

    Ohio Medicaid:

Manual & semi-electric beds are covered in the patient’s home. Full electric beds are not covered.

• Manual Beds are generally covered if:
• • the patient is bed confined (18 hours per day), and a diagnosis/condition prohibits use of an ordinary be

                  OR

OR

• Semi-Electric Bed are only covered under exceptional circumstances when there is a documentation for specific need (e.g., quadriplegia)
• Heavy Duty Beds are covered for clients who weigh more than 350 pounds.
• Extra Heavy Duty Beds are covered for clients who weight more than 650 pounds.
• Documentation: Medicaid Hospital Bed CMN. Prior authorization is required.

    Medicare:

Manual & semi-electric beds are covered in the patient’s home. Full electric beds are not covered.

• Manual Beds are covered if one or more of the following are met:
• • Patient requires positioning not possible in an ordinary bed with a need of 30 days.
  • Patient requires positioning to alleviate pain,
  • Patient requires an elevation of >30 degrees.
  • Patient requires traction equipment that may only be attached to hospital beds.

• Semi-Electric Beds are covered if in addition to meeting the general indications, the patient requires frequent changes or immediate changes in body position.
• Heavy Duty Beds are covered for clients who weigh more than 350 pounds.
• Extra Heavy Duty Beds are covered for clients who weigh more than 600 pounds.
• Documentation: A written order prior to dispensing and records for the physician file documenting need is required. No prior authorization is required.

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