Medicare Coverage of Commode Chairs
What It Is
Rental or purchase of a commode chair
Medicare Part B covers the purchase or rental of a commode chair, if prescribed by a physician, for a patient who is confined to a room and doesn't have immediate access to a regular bathroom toilet.
If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for a commode chair, contact the plan directly.
What Medicare Pays
Medicare Part B pays 80 percent of the Medicare-approved amount for the purchase or rental of a doctor-prescribed commode chair. The chair must be rented or purchased from a medical equipment supplier that's certified by Medicare.
Warning:** If the chair is rented or purchased from what is called a Medicare "participating supplier" the supplier can't charge more than the Medicare-approved amount. However, a supplier who's enrolled in Medicare but isn't an officially "participating supplier" can charge more than the Medicare-approved amount. In that case, the patient must personally pay the difference between the Medicare-approved amount and the amount the supplier actually charges (on top of the 20 percent of the Medicare-approved amount that Medicare doesn't pay).
Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:
The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?
The care must be performed or delivered by a healthcare provider who participates in Medicare.