Does Medicaid cover durable medical equipment in New York City?

Yes. All DME we supply is covered by Medicaid or HMO plans when there is a patient physician prescription and the item meets medical-necessity criteria. New York City Medicaid coverage is governed primarily by the New York State Medicaid DMEPOS Manual, and NYS updated the DME provider manuals effective July 1, 2026.

What about Medicaid Managed Care and HMO plans?

Medicaid Managed Care plans generally cover DME as a benefit, but the billing destination, prior authorization requirements, network rules and reimbursement can vary by item and by plan. We verify your specific plan before we order anything, so there are no surprise bills.

Do I need a prescription?

Yes. Every covered item requires a prescription (and for many items, supporting documentation) from your treating physician. Send us the prescription and we take it from there — you can fax it, email it, or have the office send it directly.

Who handles the prior authorization?

We do. Our team prepares the prior-authorization packet, assembles the medical-necessity documentation, submits it to Medicaid or your HMO, follows up on the determination and gets it approved. You do not need to chase the plan yourself.

How long does prior authorization take?

Simple items are often approved within a few business days; complex rehab equipment such as custom power wheelchairs can take longer because plans require an evaluation and additional documentation. We keep you updated at each step and can supply loaner or interim equipment where allowed.

What if my item is denied?

A denial is usually a documentation issue, not a final answer. We review the denial reason, gather the additional clinical justification from your physician and resubmit or appeal on your behalf.

What will I pay out of pocket?

For covered items with an approved authorization, Medicaid patients typically have no out-of-pocket cost. HMO and commercial plans may apply a copay, coinsurance or deductible; we confirm your responsibility in writing before we deliver.

How do you confirm coverage criteria and codes?

We check current HCPCS codes, coverage criteria and fees against the official NYS eMedNY DME Manual, so the claim matches what your plan expects.

Products & Services

Durable medical equipment, fitted to the person using it

All DME covered by Medicaid or HMOs with a patient physician prescription. We do the prior authorization and get it approved — then deliver, fit and service the equipment.

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23 categories

Insurance & coverage

We handle the prior authorization and get it approved. New York City Medicaid coverage follows the NYS Medicaid DMEPOS Manual (provider manuals updated effective July 1, 2026); Medicaid Managed Care plans cover DME as a benefit, though billing, prior authorization, network and reimbursement rules can vary by item and plan.

Medicaid and Medicaid Managed Care accepted
HMO and commercial plans billed directly
Prior authorization prepared, submitted and approved
Coverage criteria and HCPCS codes verified against the NYS eMedNY DME Manual

Mobility

Manual Wheelchairs & Seating

Standard, lightweight, heavy-duty and reclining wheelchairs fitted to your size and lifestyle.

Standard wheelchairs
Lightweight wheelchairs
Heavy-duty (bariatric) wheelchairs
Reclining wheelchairs
Wheelchair cushions
Back supports
Headrests
Armrests
Leg rests & elevating leg rests

Durable medical equipment, fitted to the person using it

Insurance & coverage

Mobility

Recovery & Support

Home Care

Respiratory & Sleep

Clinical Supplies

Medicaid, HMO & prior authorization questions