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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say that a standard written order (SWO) must be communicated to the supplier prior to claim 
submission. For certain items of DMEPOS, a written order is required prior to delivery (WOPD) of the item(s) 
to the beneficiary (see below). 
 
A SWO must contain all of the following elements: 
 
    Beneficiary's name or Medicare Beneficiary Identifier (MBI) 
    Order Date 
    General description of the item 
        The description can be either a general description (e.g., wheelchair or hospital bed), a HCPCS code, a 
HCPCS code narrative, or a brand name/model number 
        For equipment - In addition to the description of the base item, the SWO may include all concurrently 
ordered options, accessories or additional features that are separately billed or require an upgraded code (List 
each separately). 
        For supplies  In addition to the description of the base item, the DMEPOS order/prescription may include 
all concurrently ordered supplies that are separately billed (List each separately) 
    Quantity to be dispensed, if applicable 
    Treating Practitioner Name or NPI 
    Treating practitioner's signature 
 
Signatures must comply with the CMS signature requirements outlined in the Medicare Program Integrity 
Manual (CMS Pub.100-08), Chapter 3, Section 3.3.2.4. Signature and date stamps are not allowed. 
 
Upon request by a contractor, DMEPOS suppliers must provide documentation of the completed SWO. 
 
In those limited instances in which the treating practitioner is also the supplier and is permitted to furnish 
specific items of DMEPOS and fulfill the role of the supplier in accordance with any applicable laws and 
policies, a SWO is not required. However, the medical record must still contain all of the required SWO 
elements. 
 
WRITTEN ORDERS PRIOR TO DELIVERY (WOPD) 
 
A WOPD is a completed SWO that is communicated to the DMEPOS supplier before delivery of the item(s).  
Pursuant to Final Rule 1713 (84 Fed. Reg Vol 217), CMS may select DMEPOS items appearing on the Master 
List of DMEPOS Items potentially subject to a Face-to-Face Encounter and WOPD requirement and include 
them on a Required List. 
 
The Required List will be comprised of: 
 
    Statutorily required DMEPOS items such as Power Mobility Devices (PMDs); and 
    Additional DMEPOS items selected by CMS appearing on the Required List. 
 
Items appearing on the Required List are subject to the face-to-face encounter and WOPD requirements. 
 
CMS and the DME MACs will post on their websites the Required List of the selected HCPCS codes, once 
published through the Federal Register Notice, and the Required List will be periodically updated. The current 
required Face-to-Face Encounter and Written Order Prior to Delivery List is available here 
 
Note that the face-to-face encounter and WOPD requirements are statutorily required for PMDs, and in 
accordance with this statutory obligation, both will continue to be required, and will be included in any future 
publications of the Required List. The date of the WOPD shall be on or before the date of delivery. A WOPD 
must be completed within six (6) months after the required face-to-face encounter. For PMDs, following the 
face-to-face encounter, the treating practitioner must complete the WOPD of the item pursuant to 
1834(a)(1)(E)(iv). Upon request by a contractor, DMEPOS suppliers must provide documentation of the 
completed WOPD. You can find this information in Medicare's Local Coverage Article Standard 
Documentation Requirements for All Claims Submitted to DME MACs (A55426). 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.