PRESSURE REDUCING SUPPORT SURFACES
F2F* is REQUIRED and documentation must be provided to the supplier.
*EXCEPTION-E0181 Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty) does not require a F2F.
Valid detailed written Physician Order/Statement of Medical Necessity that contains:
- Beneficiary’s name
- Physician’s name
- Date of the order and the start date, if start date is different from the date of the order
- Clear, detailed description of the type of support surface the physician is ordering
- Physician’s signature, NPI, and signature date
GROUP 1 – Mattress overlay OR mattress
GROUP 2 – Powered OR non-powered reducing mattress
Refer to the following pages for specific information