DME Prescription Requirements
What a Valid DME Order Must Include
Medicare requires a Standard Written Order (SWO) before it will pay for DME, and that order has to include five specific elements — missing any one of them is grounds for a denied claim. Most private insurers follow a similar standard even when they don't use the exact same term.
- The patient's name and identifying information
- The date the equipment was ordered
- A general description of the item being ordered
- The quantity ordered, if more than one
- The prescribing practitioner's name, NPI, and signature
Certificate of Medical Necessity vs. Standard Written Order
A Standard Written Order establishes that the equipment was ordered; a Certificate of Medical Necessity, required for some specific DME categories, goes further and documents the clinical reasoning — diagnosis, prognosis, and expected duration of need. Not every order requires both; your supplier can tell you which applies to your specific equipment.
Proof of Delivery: The Step After the Order
A correct prescription isn't the end of the documentation trail — Medicare and most insurers also require proof of delivery (POD) once the equipment arrives, including the delivery date, a description of what was delivered, and a signature confirming receipt. Missing or incomplete proof of delivery is a separate, common reason claims get denied even when the original order was flawless.
What Happens If Documentation Is Missing
An incomplete order typically delays your equipment rather than cancelling it outright — your supplier will usually go back to the prescribing provider for the missing piece before the claim can be submitted. Bringing your prescription to your first conversation with a DME supplier, if you already have one, is the fastest way to avoid that back-and-forth.
FAQ
What is a Standard Written Order (SWO)?+
It's the specific written order Medicare requires before paying for DME, including the patient's information, order date, item description, quantity, and the prescriber's signature.
Do I need both a prescription and a Certificate of Medical Necessity?+
Not always — a CMN is only required for certain DME categories. Your supplier can confirm which documentation applies to your specific order.
What is proof of delivery and why does it matter?+
It's documentation confirming when and what equipment was delivered, typically with a signature. Missing proof of delivery can cause a claim to be denied even if the original order was correct.