CMS Pub. 100-04, ch. 24, § 50

NOTE: CMS seeks to reduce burden and modernize processes to ensure a reduction in

improper payments and an increase in customer satisfaction. The Certificate of Medical

Necessity (CMN) form and DME Information Form (DIF) were originally required to

help document the medical necessity and other coverage criteria for selected Durable

Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items. In the past, a

supplier received a signed CMN from the treating physician or created and signed a DIF

to submit with the claim. Due to improvements in claims processing and medical records

management, the information found on CMNs or DIFs is available either on the claim or

in the medical record and is redundant. Therefore, to reduce burden and increase

customer satisfaction, providers and suppliers no longer need to submit these forms for

services rendered after January 1, 2023.

• For claims with dates of service on or after January 1, 2023 – providers and

suppliers no longer need to submit CMNs or DIFs with claims. Due to electronic

filing requirements, claims received with these forms attached will be rejected and

returned to the provider or supplier.

• For claims with dates of service prior to January 1, 2023 – processes will not

change and if the CMN or DIF is required, it will still need to be submitted with

the claim, or be on file with a previous claim.

This statement applies throughout the Program Integrity Manual wherever CMNs and

DIFs are mentioned.