Provider Notice issued 05/14/14

Incontinence Supplies Monthly Limitations

The attached tables identify, by HCPCS code, the current incontinence products covered by HFS and quantity limits. Combinations of the products in Table 1 have a cumulative quantity limit of 200 per 30-day period. The products in Table 2 may be dispensed in addition to the products listed in Table 1.

As is current policy, whether prior approval is required or not, the quantity of medical supplies will be limited to the amount indicated by the ordering practitioner or to a reasonable quantity for a month, whichever is less. Providers must contact the patient prior to dispensing each item to ensure that the patient continues to want the same provider to serve his or her medical supply needs, and that the patient continues to need the items. The patient's medical eligibility must also be verified prior to dispensing the item.

Any questions regarding this notice may be directed to a DME billing consultant in the Bureau of Provider and Ancillary Services at 1-877-782-5565, option 3, then option 2.

A quantity limit of 200 per 30-day period includes the combination of the following incontinence supplies:

The following products may be dispensed in addition to the products listed in the above table: