Medicare does not cover any items for the bathroom except for a commode chair, and then only when the following Criteria has been met.
CRITERIA FOR A COMMODE CHAIR
A commode chair is covered when the patient is physically incapable of utilizing regular toilet facilities. This would occur in the following situations:
- The patient is confined to a single room, or
- The patient is confined to one level of the home environment and there is no toilet on that level, or
- The patient is confined to the home and there are no toilet facilities in the home.
An extra wide/heavy duty commode chair is covered for a patient who weighs 300 pounds or more. If the patient weighs less than 300 pounds but the basic coverage Criteria for a commode chair are met, payment will be based on the least costly medically appropriate alternative.
A mobile commode chair is not medically necessary. If basic coverage Criteria for a commode chair is met, payment will be based on the least costly medically appropriate alternative stationary commode chair, respectively.
A commode chair with detachable arms is covered if the detachable arms feature is necessary to facilitate transferring the patient or if the patient has a body configuration that requires extra width. If these additional Criteria are not met but the coverage Criteria for a commode chair are met, payment will be based on the least costly medically appropriate alternative.
- A written signed and a dated prescription is required before a commode chair is covered by Medicare