Certificate of Medical Necessity (CMN) for DME Providers Forms
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Certificate of Medical Necessity (CMN) for DME Providers Forms

Last Updated: Monday, April 03, 2023

This page contains Certificate of Medical Necessity forms for DME providers to use when communicating with Highmark.

Continuous Positive Airway Pressure (CPAP)

Customized Manual Wheelchair

Enteral Nutrition

General

Hospital Bed

Initial Insulin Pump Request

Lymphedema Pump

Motorized Wheelchair

Osteogenesis Stimulators

Oxygen

Power Operated Vehicle (POV)

Seat Lift Mechanism

Support Surfaces

Therapeutic Shoes

Transcutaneous Electrical Nerve Stimulator (TENS)

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