CMS Pub. 100-02, ch. 7, § 50.4.1.3

Nonroutine supplies are identified by the following conditions:

1. The HHA follows a consistent charging practice for Medicare and other patients

receiving the item;

2. The item is directly identifiable to an individual patient;

3. The cost of the item can be identified and accumulated in a separate cost center;

and

4. The item is furnished at the direction of the patient's physician or allowed

practitioner and is specifically identified in the plan of care.

All nonroutine supplies must be specifically ordered by the physician or allowed

practitioner or the physician or allowed practitioner's order for services must require the

use of the specific supplies to be effectively furnished.

The charge for nonroutine supplies is excluded from the per visit costs.

Examples of supplies that can be considered nonroutine include, but are not limited to:

1. Dressings/Wound Care

• Sterile dressings;

• Sterile gauze and toppers;

• Kling and Kerlix rolls;

• Telfa pads;

• Eye pads;

• Sterile solutions, ointments;

• Sterile applicators; and

• Sterile gloves.

2. I.V. Supplies

3. Ostomy Supplies

4. Catheters and Catheter Supplies

• Foley catheters; and

• Drainage bags, irrigation trays.

5. Enemas and Douches

6. Syringes and Needles

7. Home Testing

• Blood glucose monitoring strips; and

• Urine monitoring strips.

Consider other items that are often used by persons who are not ill or injured to be

medical supplies only where:

• The item is recognized as having the capacity to serve a therapeutic or diagnostic

purpose in a specific situation; and

• The item is required as a part of the actual physician or allowed practitioner

prescribed treatment of a patient's existing illness or injury.

For example, items that generally serve a routine hygienic purpose, e.g., soaps and

shampoos and items that generally serve as skin conditioners, e.g., baby lotion, baby oil,

skin softeners, powders, lotions, are not considered medical supplies unless the particular

item is recognized as serving a specific therapeutic purpose in the physician or allowed

practitioner's prescribed treatment of the patient's existing skin (scalp) disease or injury.

Limited amounts of medical supplies may be left in the home between visits where

repeated applications are required and rendered by the patient or other caregivers. These

items must be part of the plan of care in which the home health staff is actively involved.

For example, the patient is independent in insulin injections but the nurse visits once a

day to change wound dressings. The wound dressings/irrigation solution may be left in

the home between visits. Supplies such as needles, syringes, and catheters that require

administration by a nurse should not be left in the home between visits.