Department of Medical Assistance Services
DME Fee Schedule


Nursing Facility Quality Improvement Resources APPENDIX B (DME Fee Schedule)
Bullet Point Image Appendix B 1- Apnea, Respiratory, Oxygen and Vents 2018
Bullet Point Image Appendix B 2- Bandages, Dressings, Gauze and Tape 2018
Bullet Point Image Appendix B 3 -Beds Pans, Urinals, Incontinence, Catheters, and Irrigation Equip and Supplies 2018
Bullet Point Image Appendix B 4 - Beds, Mattresses, and Accessories 2018
Bullet Point Image Appendix B 5 - Burn Garments 2018
Bullet Point Image Appendix B 6 – Canes, Crutches and Walkers 2018
Bullet Point Image Appendix B 7 – Communications Devices 2018
Bullet Point Image Appendix B 8 – Decubitus and Ulcer Products 2018
Bullet Point Image Appendix B 9 – Diabetic Products 2018
Bullet Point Image Appendix B 10 – Dialysis Equipment and Supplies 2018
Bullet Point Image Appendix B 11 – Dry Heat application, TENS, NMES 2018
Bullet Point Image Appendix B 12 – Elastic Support 2018
Bullet Point Image Appendix B 13 – EPSDT only
Bullet Point Image Appendix B 14 – Feeding pumps, Nutritional supplements, Feeding Kits, and Tubes 2018
Bullet Point Image Appendix B 15 – I.V. Service Day Rate, Stands, Needles and Supplies 2018
Bullet Point Image Appendix B 16 – Miscellaneous Durable and Expendable Supplies 2018
Bullet Point Image Appendix B 17 – Orthotics 2018
Bullet Point Image Appendix B 18 – Ostomy and Colostomy Pouches 2018
Bullet Point Image Appendix B 19 – Traction Equipment 2018
Bullet Point Image Appendix B 20 – Wheelchairs and Accessories 2018
Bullet Point Image Appendix B 21 – Excel Version with all Categories of Appendix B