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Hospital Bed - Customer Checklist

West Palm Beach: 561-964-6767

Boynton Beach: 561-733-2331



The checklist below is derived from Medicare’s Coverage criteria for a Hospital Bed. Without the below criteria being fully and legible documented in the physician's chart notes and Rx, Medical justification has not been met.


Checklist for Face-to-Face Examination Chart Notes for a Hospital Bed 


Criteria for F2F Chart Notes for Hospital Bed:   

▢  Is the Reason for the face-to-face encounter conducted by the physician, to evaluate and/or treat the condition that supports the item(s) of DME ordered. –(“follow-up” is not acceptable)

▢  Is there a description of how the diagnosis limits the patient’s condition

▢  Is there an indication that the beneficiary (one of the below): 

▢  Has a medical condition which requires positioning of the body in ways not feasible with an ordinary bed- condition must be clearly stated  -or- 

▢  requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain, and why -or-

▢  requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration -or-

▢  Requires traction equipment, which can only be attached to a hospital bed

▢  Indication if alternate methods such as pillows and wedges have been ruled out and why.

▢  Indication that requires frequent changes in body position and/or has an immediate need for a change in body position w/ explanation. 

Detailed Written Order- 

▢  beneficiary's name, 

▢  item of DME ordered,

▢  the prescribing practitioner's National Provider Identifier (NPI), 

▢  signature of the ordering practitioner and  

▢  date of the order.

▢  Is the Detailed written order dated after the F2F, but not more than 6 months old

Please Note: Medicare pays for hospital bed rentals only. The hospital beds that we rent are Full Electric Hospital Beds (FEHB). These types of beds are an out of pocket upgrade to the Fixed Hospital Bed that Medicare covers. To obtain a Full Electric Hospital Bed, upon qualification, we will apply Medicare's Fee Schedule to the rental rate of a Full Electric Hospital Bed. 

[FEHB Rental $180/month - Medicare ~~$60/month] = Out of pocket $85/month] 13/months) 


Physicians: We invite you to create the Face to Face Chart note through

Medicare Compliant paperwork the first time!

Please fax your referrals and documentation to 561-290-1434

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