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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Specialized supplies and equipment

Page posted: 10/1/03

Page reviewed: 1/3/14

Page updated: 5/30/17

Legal authority

Federally approved BI, CAC and CADI waiver plans, Minn. R. 9505.0310


Specialized supplies and equipment: Devices, controls or medical appliances or supplies specified in the community support plan.

Covered services

This service covers specialized supplies and equipment that enable the person to increase his/her ability to:

  • • Perceive, control or interact with his/her environment or communicate with others
  • • Perform activities of daily living.
  • Specialized supplies and equipment includes:

  • • Durable and non-durable medical equipment and supplies not available or denied under the state plan
  • • Electronic tablet as both part of a system of environmental controls and as an augmentative communication device
  • • Equipment repair and maintenance, unless covered by the manufacturer's warranty
  • • Items necessary for life support
  • • Items that exceed the limits set for Medicaid State Plan- covered services
  • • Personal emergency response systems
  • • Pre-moistened cleansing wipes to aid in disability-related continence care
  • • Supplies necessary for the proper functioning of such life support items
  • • Thickening agents when there is a determination of medical need
  • • Upgrades & add-ons to otherwise approved state plan items that are determined necessary to meet the needs identified in the person’s consumer support plan.
  • The purchase price includes necessary training or instruction on the use of specialized supplies and equipment.

    Non-covered services

    This service does not cover:

  • • All prescription and over-the-counter medications, compounds and solutions, and related fees including premiums and co-payments
  • • Items covered under third-party payer liability or that require co-insurance or deductibles
  • • Items that do not provide direct medical or remedial benefit to the person
  • • Oral nutritional products, electrolyte products, foods (including organic or special diet needs), organ extracts and over-the-counter food supplemental products.
  • Electronic tablet

    If the person on the waiver uses an electronic tablet only for purposes of augmentative communication, the device is funded through the state plan as durable medical equipment.

    If the person on the waiver uses an electronic tablet as part of a system of environmental controls and as an augmentative communication device, the electronic tablet is funded through the waiver under specialized supplies and equipment.

    Provider standards and qualifications

    Specialized supplies and equipment is an approval-option: purchased-item service. For more information, see CBSM – Waiver/AC service provider overview.

    Authorization, rates and billing

    The lead agency authorizes specialized supplies and equipment at the market rate. For more information, see Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

    To authorize specialized supplies and equipment, the lead agency enters a:

    1. Service agreement line item for T2029 (waiver specialized medical supply and equipment) or E1399 (AC specialized medical supply and equipment).
    2. Short note on the line item to identify the supply or equipment.
    3. Detailed description of the supply or equipment on the DHS Comment Screen.

    MMIS automatically:

  • • Adds reason code 864 to the line item
  • • Places a message on the provider letter to remind providers the claim may not be paid if another funding source can pay for the item.
  • Personal emergency response systems

    The lead agency uses the following codes to authorize personal emergency response systems:

  • S5160 – Emergency response system installation and testing with $500 maximum
  • S5161 – Emergency response system monthly service fee (excludes installation and testing) with $110 maximum monthly
  • S5162 – Emergency response system purchase with $1,500 maximum.
  • The maximum cost for all PERS codes is $3,000 per year.


    Do not use S5160, S5161 and S5162 codes on CDCS service agreements. Continue to authorize these costs under T2028.

    Do not authorize PERS codes with 24-hour customized living codes in the same period of time, with the exception of PERS pendant purchases.

    Authorization maximums

    The lead agency may not authorize specialized supplies and equipment for more than $3,909 per person, per year.

    The authorization maximum is per person during a 365-day calendar period. DHS determines the 365-day span by counting back from the SA header end date. It may include previous service agreements. The lead agency may authorize up to $3,909 every year (365 day span). Once the authorization maximum has been reached, additional spending must wait until the next year. There are no exceptions to this limitation.

    Additional resources

    CBSM — BI, CAC, CADI and DD waivers general process and procedures
    CBSM — Monitoring technology usage

    CBSM — Waiver oral and enteral nutritional products

    MHCP Provider Manual — Equipment and supplies

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