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What is DME in Healthcare? An Expert Overview

The Parachute Health Team

Over 2.5 million Americans rely on durable medical equipment (DME) to give them dignity and autonomy while suffering from a range of chronic, often debilitating conditions.1 But navigating DME ordering, coverage, and delivery remains complex for patients and providers alike.

The following guide helps shed light on those complexities to ensure every patient can access essential equipment with ease. It reveals how streamlined ordering processes can dramatically improve patient outcomes and reduce administrative burden, answering critical questions like:

  • What qualifies as durable medical equipment under Medicare?
  • How does the DME ordering process actually work?
  • What are the biggest challenges patients face when obtaining DME?
  • How can digital ordering transform DME delivery?

Durable Medical Equipment: An Overview

What Is DME in Healthcare?

In medical terms, durable medical equipment (DME) refers to devices designed for long-term use by individuals with disabilities, injuries, or chronic health conditions. This includes multiple distinct sub-categories, including: 

  • Mobility Aids: The most common and visible forms of DME, including manual wheelchairs, power wheelchairs, walkers, scooters, and specialized seating systems. These devices restore independence and prevent dangerous falls that could lead to hospitalization.

  • Respiratory support: This category encompasses oxygen concentrators, CPAP and BiPAP machines, nebulizers, and related accessories. These devices enable patients with breathing disorders to maintain adequate oxygen levels and avoid life-threatening respiratory emergencies.

  • Daily living aids: Includes hospital beds, patient lifts, commode chairs, and shower chairs. These devices allow patients to perform essential activities safely at home rather than requiring institutional care.

  • Therapeutic devices: These include glucose monitors, infusion pumps, electrical stimulation units, and wound care equipment. These devices enable continuous treatment and monitoring that can prevent complications and reduce the need for frequent clinical visits.

However, most healthcare professionals rely on Medicare’s strict criteria to determine what constitutes DME.

What DME is Covered by Medicare?

Medicare’s coverage terms define DME as any equipment that is:

  • Durable (can withstand repeated use)
  • Used for a medical reason
  • Typically only useful to someone who is sick or injured
  • Used in your home
  • Expected to last at least 3 years 

Any equipment that meets these criteria is covered by Medicare, but this leaves a lot of equipment that does not qualify for reimbursement.

What DME is Not Covered by Medicare?

Many items that patients require to manage their conditions outside of the hospital environment fail to meet Medicare’s DME criteria, including:

  • Items designed for comfort and ease, like air conditioning units
  • Disposable items, such as incontinence supplies

As a result, patients will most likely have to purchase these items for themselves. But there are also edge cases, such as motorized scooters, which may qualify as DME—depending on the specifics of the case. For example, Medicare will cover motorized scooters if the patient is unable to undertake daily living activities even with the support of a cane or walker.

Three Ways DME Helps Patients Thrive

The availability of high-quality DME empowers patients with a wide range of conditions and leads to:

  1. Increased Autonomy

    DME gives patients more autonomy than they would otherwise have—restoring independence, enabling return to their routines, and allowing them to remain at home rather than enter an institution. Research has also shown that DME can positively influence patients’ self-esteem; equipment like glucose monitors often gives patients with chronic conditions a greater sense of control over their illness.2

  2. Improved Health Outcome

    Increased autonomy and the ability to return home are linked with better overall care outcomes. From improved sleep to higher patient satisfaction, the ability to recover in a familiar environment surrounded by loved ones has a profound effect on patient health. One meta-analysis even suggests that home-based care—facilitated by DME—lowers patients’ risk of readmission or long-term care admission.3

  3. Reduced Care Costs

    Strategic, proactive deployment of DME can deliver substantial economic benefits. Take mobility equipment: over six million Americans suffer injuries through falls, with the average cost-per-incident for a Medicare beneficiary estimated at around $8,500. One study suggests wider availability of DME could therefore save both payors and patients huge sums; across three areas of equipment, it estimates a potential $100 billion annual saving.4

    But in order to realize these benefits, clinicians, DME providers, and payors must coordinate efficiently to process and fulfill complex product requests:

Understand the DME Ordering Process

What Role Do Clinicians Play?

Clinicians kickstart every DME order, as equipment is often essential to continue treatment or discharge patients. They are responsible for: 

  • Determining medical necessity: This includes providing a precise diagnosis and outlining how the equipment supports the patient’s treatment plan or daily function

  • Documenting the patient’s condition: Without accurate clinical notes and justification, authorizations may be denied, delaying patient access to essential equipment. 

  • Writing detailed prescriptions that meet payor requirements: This is essential to enable DME providers to process orders and ensure proper reimbursement from payors.

What Is a DME Provider?

DME providers are accredited, Medicare‑enrolled providers who do more than just fill orders—they verify insurance, process claims, deliver equipment, and train users in safe operation. High‑quality providers continue providing maintenance and support, ensuring equipment remains functional and dependable for patients in the long run.

Who Decides What Gets Covered?

Payors—including Medicare, Medicaid, and commercial insurers—set coverage rules by defining medical necessity, establishing payment terms, and requiring documentation for DME approval. Through tools like prior authorization and coverage limits, they work to balance patient access with cost control. This gatekeeping ensures that the right patients receive the right equipment at the right time.

The DME Ordering Process

A well‑structured workflow ensures effective and appropriate use while safeguarding patients and payors:

  1. Clinical Assessment & Documentation

    Clinicians assess patients and record medical necessity in the record, explaining clearly how the equipment supports diagnosis and daily function.

  2. Standard Written Order (SWO)

    The SWO is the formal prescription insurers need. It must specify the equipment, relevant diagnoses, and expected duration of use.

  3. Face‑to‑Face & Prior Authorization

    For high‑cost or high‑risk items on CMS’s Master List, clinicians must meet the patient in person and obtain prior approval—helping prevent misuse of expensive equipment.

  4. Provider Fulfillment

    Accredited DME providers verify insurance eligibility, submit claims, deliver equipment, and offer patient training. The best DME providers also provide follow‑up care to maintain safety, compliance, and effectiveness.

Why This Workflow Matters (and What’s at Stake)

Care delivered via DME providers is demonstrably better: a recent study showed that patients using DME providers had 35% lower total costs of care—about $3,875 less per year compared to those using pharmacy channels—alongside better adherence and fewer emergency visits.5 This highlights the vital role DME providers play in keeping patients healthier, supporting long-term health outcomes, and reducing unnecessary spend.

Transforming DME Through Digital Innovation

Traditional DME ordering relies heavily on manual processes that create delays, errors, and frustration for patients and providers alike. Fax-based orders routinely get lost, require multiple clarifications, and lack real-time status visibility.

Digital ePrescribing platforms like Parachute Health eliminate these inefficiencies by connecting clinicians directly with qualified DME providers through secure, automated workflows. This connected digital ecosystem increases transparency and accountability to help patients get their DME faster.

The Parachute Platform's AI-powered intake digitizes fax orders, built-in logic validates documentation completeness, and an exclusive patient tracker allows patients to follow their order status via mobile web app and text messages⁠.

Over 270,000 clinicians and 3,000 DME provider locations use the Parachute Platform to:

  • Complete orders 10x faster
  • Eliminate 80% of manual work
  • Achieve 98% clean order rates*

This efficiency directly translates to faster equipment delivery for patients who need DME to maintain their health and independence.

Ready to streamline your DME ordering process?

* Clean orders are orders that are accepted by the DME providers upon first submission.
1 https://pmc.ncbi.nlm.nih.gov/articles/PMC8140591/
2 https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-13-467
3 https://www.nature.com/articles/s41746-024-01040-9
4 https://www.vgm.com/communities/how-investing-in-dme-could-save-billions-of-dollars
5 https://www.northcoastmed.com/dme-vs-pharmacy-sourced-cgm-study