9.0 Self-care equipment and supplies benefits list

Effective date: March 21, 2025

The following Medical Supplies and Equipment (MS&E) list contains self-care items and services eligible under the Non-Insured Health Benefits (NIHB) program for eligible First Nations and Inuit. Further you'll find information on coverage policies, item codes, requirements for prior approval and applicable recommended replacement guidelines.

Table of contents

9.1 General information

9.1.1 Benefit policies

General information common to all medical supplies and equipment (MS&E) can be found in the general policies.

9.1.2 Prescriber and provider requirements

Prescriptions or recommendations for coverage must be initiated by the health professionals identified as prescribers or recommenders of the specific item as listed in the tables. Items that are prescribed by prescribers or recommenders not recognized by NIHB will lead to denials or reversal of claims.

The following is a list of NIHB-recognized prescriber or recommender abbreviations found in this segment of the benefits list. Refer to the prescriber section of the item tables below to identify the eligible prescriber or recommender of a specific item:

  • LPN/RPN — Licensed Practical Nurse or Registered Practical Nurse when within their scope of practice in their province or territory
  • MD — Physician
  • NP — Nurse Practitioner
  • OT — Occupational Therapist
  • PSY — Psychologist
  • PT — Physiotherapist
  • RD — Registered Dietitian
  • RM — Registered Midwife
  • RN — Registered Nurse
  • RRT — Registered Respiratory Therapist
  • SLP — Speech-Language Pathologist

The following is a list of NIHB-recognized provider abbreviations found in this segment of the benefits list. Refer to the provider section of the item tables below to identify the eligible provider of a specific item:

  • GEN — Enrolled general MS&E or pharmacy provider

9.1.3 Prior approval requirements

General prior approval requirements can be found in the general policies.

To initiate the prior approval process, the Self-care Prior Approval Form, found on the Express Scripts Canada NIHB provider and client website, must be completed in full and submitted to your NIHB regional office along with the following supporting documentation:

  • the prescription or recommendation or referral form signed by an NIHB-recognized prescriber for the requested benefit
  • detailed assessment as required
  • relevant information the provider, physician, nurse practitioner, occupational therapist, psychologist or physiotherapist may have to support the request
  • an explanation of benefits from any third-party coverage available to the client, for example, provincial plan, workers' compensation board, private insurance, education plan, etc.

9.1.4 Exclusions

In addition to the general exclusion policy listed in the general policies, the following items are excluded from the self-care benefit and are not considered for coverage or appeal under the NIHB program:

  • environmental protection devices and supplies, for example, air cleaners, filters, UV protection garments and lotions, etc.
  • permanently fixed equipment
  • equipment with a rated capacity that would be unable to bear the client's weight
  • lift chairs
  • child's regular feeding bottle and teat

9.1.5 Warranties

Providers must honour the manufacturer's warranty.

9.1.6 Repairs

Repairs that are not covered under the warranty are eligible for coverage when supported by proper documentation.

The following rules apply:

  • prior approval is required for repairs
  • request must include detailed cost breakdown of parts, labour time and rates
  • repairs must have a minimum warranty of 90 days

A description of all repairs with dates, detailed cost breakdown of parts, labour time and rates must be kept on file for each client.

Note: The NIHB program will not cover the labour cost for repairs that are covered under the warranty.

9.1.7 Replacement requirements

Recommended replacement guidelines indicate the quantity and frequency at which a benefit item will be eligible for coverage. Recommended replacement guidelines are based on a client's customary medical needs and the typical device's lifespan.

Replacement is subject to the same process as the original purchase.

All replacement requests require a new prescription.

For more general information, see section 1.12 Recommended replacement guidelines.

9.1.7.1 Early replacement requirements

Coverage requests for any early replacement require prior approval, a new prescription as well as documentation supporting the need for early replacement. The client must meet program and equipment specific eligibility criteria.

Early replacement of items may be considered when 1 of the following has occurred:

  • there is a substantial change in a client's medical condition, for example, substantial change in weight, etc. and the item no longer meets the client's needs
  • the item is no longer functioning properly, has deteriorated during typical use and is no longer under warranty where the cost of repair exceeds the cost of a new item

The program will not cover the replacement of lost items, stolen items, or items that are damaged due to misuse or negligence.

9.1.8 Services included in the NIHB price

The following services must be included in the NIHB price to be considered for coverage:

  • initial assessment to determine the type of benefit required based on health professional recommendations
  • dispensing of the benefit including the necessary adjustments and fitting, setup and installation when appropriate
  • follow-ups: all ongoing care including follow-up visits, necessary adjustments, telephone calls and correspondence
  • client education and instructions on the effective use, safety and care of the equipment and supplies

9.1.9 Terminology

Item code

The item code is an 8-digit code that identifies the benefit being requested and is submitted to Express Scripts Canada for billing purposes.

Prior approval

A program coverage confirmation is issued by an NIHB regional office to a provider to ensure that the client is eligible for specific medical supplies and equipment benefits. The approval is issued primarily for items identified as requiring prior approval before being billed to the program. All claims, including claims accompanied by prior approvals, are subject to claim verification.

Recommended replacement guidelines

The recommended replacement guidelines set a maximum number of each item a client may receive over a given period or frequency. Coverage of additional items may be considered on a case-by-case basis. For requests exceeding the recommended replacement guidelines, prior approval is required.

NIHB price

NIHB price information is listed in the MS&E price files, located on the Express Scripts Canada NIHB provider and client website.

When an NIHB price is established for an item, it must not be claimed by default. To be eligible for payment, providers must adhere to the NIHB program's terms and conditions set out in their MS&E provider billing agreement and submit eligible claim amounts in accordance to the MS&E Claims Submission Kit and reimbursement policies.

9.2 Bathing and toileting aids

9.2.1 Bathing

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400295 Bath chair MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years
  • 4 height adjustable legs
  • width at base of legs must fit inside width of tub
  • with or without backrest
  • seat may be padded, or smooth or textured plastic, with or without perineal cutout
  • may include arms
  • must have non-skid rubber tips or suction feet on the legs
  • the client's weight must be within the weight capacity of the device
99400474 Bath chair lift, battery powered MD, NP, OT, PT GEN Yes 1 every 5 years  
99400935 Bath chair lift, bariatric battery powered, purchase MD, NP, OT, PT GEN Yes 1 every 5 years  
99400937 Bath chair lift, battery   GEN Yes 1 per year  
99400936 Bath chair lift, battery powered, rental MD, NP, OT, PT GEN Yes   Rented for 1 month at a time
99400303 Commode shower chair MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes 1 every 5 years  
99401430 Long-handled sponge MD, NP, OT, PT, RN, LPN/RPNTable note 1Table note 2 GEN No 1 per year  
99400649 Tub transfer rail, non-permanent MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years
  • assists in transferring in or out of bathtub
  • non-permanent
  • clamp-on style
  • does not include rails or bars that attach to the tub, surround, or wall with screws or suction mechanisms
  • powder or plastic coated or textured grip surface
  • the client's weight must be within the weight capacity of the device
99400301 Mat non-slip tub MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 2 years  
99400304 Tub transfer bench MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years
  • height adjustable legs: two legs sit on outside of tub, 2 on inside of tub, and seat extends over the bathtub wall
  • padded or smooth plastic
  • the client's weight must be within the weight capacity of the device
99400305 Tub transfer board MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years
  • board constructed of plastic with a smooth or textured surface. Often with holes for drainage and a raised handle to assist with transfers
  • sits across edges of tub, usually secured with adjustable rubberized stops underneath the board
  • acts as a seat for bathing
  • the tub must have edges on both sides for the board to sit on and the board must be appropriate width for the tub
  • the client's weight must be within the weight capacity of the device
  • the transfer board to be used for all surfaces should use the item code 99400328
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.2.2 Toileting

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400294 Bedpan MD, NP, OT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years  
99400296 Commode, standard, purchase MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years
  • variable height
  • the client's weight must be within the weight capacity of the device
99400890 Commode, wheeled, purchase MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400298 Raised toilet seat, standard MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years  
99400299 Raised toilet seat, standard with arm MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years
  • armrests attached to raised toilet seat
  • must have clamps to secure to toilet bowl
    or
  • molded plastic construction with locking mechanism for safe secure fit to toilet
  • fits elongated or standard toilet bowl. may have sloped opening for peri-fit
  • the client's weight must be within the weight capacity of the device
99400302 Safety frame for toilet MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years
  • attaches to existing toilet seat bolts can be used separately or with a raised toilet seat
  • the client's weight must be within the weight capacity of the device
99400306 Urinal MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years  
99400297 Commode, rental MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes   Rented for 1 month at a time
99400878 Toilet tissue aid MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years
  • a wand, often constructed of smooth plastic, with a grasping mechanism at 1 end to hold toilet paper, and a release mechanism at the other end
  • used to assist with toilet hygiene for those who may have difficulty reaching due to a medical issue, decreased range of motion in their upper extremities, or limited dexterity
  • devices constructed of a material that could corrode are not eligible for coverage
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.3 Cushion and protective aid

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400308 Elbow protector, 1 pair MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 year  
99400310 Heel protector, 1 pair MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 per year  
99400315 Positioning wedge MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years A triangular foam wedge, generally with a 7, 10 or 12-inch height, covered in fabric, to be used on the bed to:
  • elevate the upper body for those with respiratory issues or aspiration risk that require the head of bed elevation, or with pain that impacts their ability to sleep in a supine position
    or
  • support the body in a side-lying position to offload pressure for those with a risk of skin breakdown

Must be large enough to support the client's entire upper body.
or
A foam rectangle with 1 sloped end, covered in fabric, to be used on the bed to:
  • elevate the legs for those with lower extremity edema or with pain that impacts their ability to sleep in a supine position

Must be large enough to support the client's legs.

Standard residential bed pillows, cervical pillows and other shaped pillows are not eligible for coverage.
99400316 Quad knee separator MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 3 years  
99400311 Ring cushion MD, NP, OT, PT, RM, RN, LPN/RPNTable note 1 GEN No 1 every 3 years  
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.4 Dressing aid

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400277 Button hook MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400278 Dressing stick MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99401429 Hip kit MD, NP, OT, PT, RN, LPN/RPNTable note 1Table note 2 GEN No 1 every 5 years
  • Includes sock aid, long-handled sponge, reacher, long-handled shoe horn
  • For clients with:
    • reaching limitations related to hip or knee surgery, arthritis, frozen shoulder, conditions impacting spinal range of motion, obesity, or other range of motion limiting conditions, or
    • shortness of breath or dizziness with forward bending
99400279 Long handle shoe horn MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400280 Reacher MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400281 Sock or stocking aid MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.5 Feeding

9.5.1 Breastfeeding aids

The infant's date of birth must be indicated on the prescription or written recommendation.

Electric breast pump purchase or rental is considered for coverage only once the child is born and when a parent or infant presents medico-physical complications hindering the normal physiological process of chestfeeding. Prior authorization and medical documentation are required to support the request.

Information to provide includes:

  • the medical justification supporting the need for the electric breast pump
  • the date of birth
  • the infant's weight
  • the length of time the electric breast pump is needed

NIHB has created an Electric Breast Pump Recommendation Form, found on the Express Scripts Canada NIHB provider and client website, that can be printed and taken to the prescriber for ease of application.

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400317 Breast pump, manual MD, NP, RM, RN, LPN/RPN, RD GEN No 1 per birth event  
99400658 Breast pump, electric, rental MD, NP, RM, RN, RD GEN Yes  
  • rented for 1 month at a time
  • in areas where the rental is not available or the purchase is more cost-effective, consider the coverage of a standard electric breast pump
  • all supplies necessary to operate the hospital-grade electric breast pump are included in the monthly rental fee
99401153 Breast pump, electric, purchase MD, NP, RM, RN, RD GEN Yes 1 every 3 years  
99400932 Nipple shield MD, NP, RM, RN, LPN/RPN, RD GEN No 6 shields every 3 months Maximum coverage of 6 months

9.5.2 Feeding aids

9.5.2.1 Specialized feeding bottles and teats

The child, 0-18 years old, presents with complex feeding challenges where a regular feeding bottle and teat do not meet their needs.

Information required:

  • completed and signed prior approval form
  • device make, model, cost, and quantity of item requested
  • prescription
  • completed clinical feeding and swallowing assessment*, which includes:
    • diagnosis
      • note that general information such as feeding difficulty is not sufficient information to support review
    • physical concerns, for example, cleft lip, cleft palate, high-arched palate, syndromic sequences, etc.
    • oral motor skills, for example, poor lip seal, reduced tongue movement, reduced gag reflex, etc.
    • feeding or swallowing concerns, for example, choking, coughing, reduced sucking, etc.
    • current diet, including safe and unsafe consistencies
    • recommendation for specialized feeding bottles and teats
    • other relevant information to support review
  • replacement teat will be considered when the client meets the criteria for the specialized feeding kit and the replacement teat are required for 1 of the following reasons:
    • damaged teat, for example, cracked, leaking, torn, etc.
    • different teat size is required, for example, size included in the kit is not appropriate for the child's developmental age or functional feeding skills, or the child has outgrown the teat size

*A Specialized Feeding Bottles and Teats Assessment Form is available on the Express Scripts Canada NIHB provider and client website. When completed and signed by an NIHB-recognized prescriber, this form can also be used as the prescription or recommendation for specialized feeding bottles and teats. Note: if another feeding and swallowing assessment report is submitted, the clinician must include the required assessment information.

Specialized feeding kits and replacement teat purchase will be considered for coverage only once the child is born.

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99401279 Adaptive Cup MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 per year  
99400287 Built-up handle or universal cuff MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400288 Food guard or bumper MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400289 Non-slip placemat MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99401133 Overbed table, purchase MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes    
99401145 Overbed table, rental MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes   Rented for 1 month at a time
99400290 Specialized utensil fork or spork MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400292 Specialized utensil, spoon MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400291 Specialized utensil, knife MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99401367 Kit, Specialized feeding bottle and teat MD, NP, RM, SLP, RN, OT GEN Yes 8 bottles and 8 teats every 6 month
  • includes: bottles, teats, valves, etc.
  • for complex feeding challenges where the child cannot use a regular feeding bottle and teat to obtain adequate nutrition.
  • maximum of 8 bottles and 8 teats regardless of packaging quantities
99401368 Teat, Replacement for specialized feeding kit MD, NP, RM, SLP, RN, OT GEN Yes 4 teats every 3 months
  • for damaged teats or if a different teat size is required
  • teat replacement should be considered when it is more cost-effective than kit replacement
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.5.3 Enteral feeding

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400476 Adhesive remover, 50 wipes per box or 50ml per bottle MD, NP, RN, RD GEN No 6 boxes per year For the long-term use of adhesives, for example, ostomy supplies, dressings, tape
99400286 Enteral feeding, nasogastric tube MD, NP, RN, RD GEN No 24 per year  
99400655 Enteral feeding, supplies, gastrostomy catheter or tube MD, NP, RN, RD GEN No 12 per year Also included: jejunal tube or a MIC-KEY jejunal tube
99400656 Enteral feeding, supplies, extension set MD, NP, RN, RD GEN No 24 per year Device that connects to the main feeding system. Could Include extension sets such as a bolus or a Y extension set, for feeding bag system

Higher frequencies will be considered on a case-by-case basis when medical justification is provided
99400657 Enteral feeding, supplies, adaptor plug MD, NP, RN, RD GEN No 12 per year Adapter which provides a connection between feeding sets and tubes, or extension sets
99400767 Enteral feeding, button (tube) MD, NP, RN, RD GEN Yes 3 per year Low profile G-tube (button) which lays on top of the abdominal wall, kept in place by a water filled balloon and is used for providing nutrition and medication
99401124 Backpack for feeding pump MD, NP, RN, RD, OT GEN Yes 1 per year  
99400285 Feeding pump, bag MD, NP, RN, RD GEN No 1 per day Includes feeding bag with tubing (spike set). It can include a dual bag set such as a feed and flush bag combination

Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400284 Feeding pump pole (iv pole) MD, NP, RN, RD, OT, LPN/RPN GEN Yes 1 per lifetime  
99400283 Feeding pump, purchase MD, NP, RN, RD GEN Yes 1 every 5 years Medical documentation that establishes the client's inability to receive feeding through gravity
99400282 Feeding pump, rental MD, NP, RN, RD GEN Yes    
99400530 Feeding syringe, 3cc, disposable MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400535 Feeding syringe, 5cc, disposable MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400539 Feeding syringe,10 cc, disposable MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400548 Feeding syringe, 20cc, disposable MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99401246 Feeding syringe, other, disposable MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400653 Gravity feeding bag MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Gravity feeding bag without tubing

Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400651 Gravity feeding, delivery set with bag MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Combination of feeding bag with tubing

Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400652 Gravity feeding, delivery set without bag MD, NP, RN, RD, LPN/RPN for renewals only GEN No 1 per day Tubing from a gravity feeding set, without the bag

Higher frequencies will be considered on a case-by-case basis for premature or immunocompromised children and for transplant patients
99400654 Gravity feeding, rigid container MD, NP, RN, RD, LPN/RPN for renewals only GEN No 24 per year  
99400411 Protective skin wipes or spray MD, NP, RN, RD GEN No 4 per year  

9.6 Gender identity

Providers must keep the following information in the client's file:

9.6.1 Upper body

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400921 Bra inserts, pair MD, NP, PSY GEN No 1 every 2 years  
99400922 Brassiere for bra insert MD, NP, PSY GEN No 3 per year  
99400920 Compression - chest binder MD, NP, PSY GEN No 2 per year  

9.6.2 Lower body

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400923 Compression - gaff or shorts MD, NP, PSY GEN No 2 per year  
99400927 Female urination aid (stand-to-pee device) MD, NP, PSY GEN No 1 per year  
99400924 Packer (phallus) MD, NP, PSY GEN No 1 per year  
99400926 Packer securement (strap, harness or brief) MD, NP, PSY GEN No 1 per year  
99400925 Packer with stand-to-pee MD, NP, PSY GEN No 1 per year  
99400928 Vaginal dilator, kit (4) MD, NP, PSY GEN No 1 every 5 years  
99400929 Vaginal dilator, single MD, NP, PSY GEN No 1 every 5 years  

9.7 Lifting and transfer

9.7.1 Bed assist rail

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400322 Bed assist rail, purchase MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 10 years
  • includes swivel, pivot or static rail
  • non-permanent
  • may secure to the bed frame with hardware or the boxspring with strapping, or have a base that sits between the boxspring and mattress
  • the client's weight must be within the weight capacity of the device
  • rented for 1 month at a time
99400323 Bed assist rail, rental MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes  
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.7.2 Lift

The program only covers portable tracking systems. Ceiling lift where permanent tracking is already installed or covered by another program may be eligible for coverage.

Eligibility criteria:

  • the client has a chronic, long-term disability resulting in an inability to safely transfer from one position to another, which requires assistive technology to lift and transfer the client between their bed and their wheelchair or the bathroom. Note: NIHB will only approve lifts for transfers between these surfaces
  • the client's weight is within the weight capacity of the device
  • the client has no other lift in place that will meet their needs
  • the client has been assessed in their home environment by an occupational therapist or physiotherapist
  • if the client is funded for a floor lift and their medical condition changes significantly, a request for a ceiling lift may be considered

9.7.2.1 Information required

Prior approval is required. Assessment from an occupational therapist or physiotherapist must include:

  • the need for the item
  • the client's anthropometric measurements including height and weight
  • the client's medical, physical status and functional level, for example, mobility
  • other relevant information
  • justification is required for specialized sling requests
  • device manufacturer, model, and weight capacity
  • completed manufacturer's order sheet
  • installation quote including type and locations where portable track is being considered
Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400953 Ceiling lift, accessories MD, NP, OT, PT GEN Yes 1 every 2 years  
99400949 Ceiling lift and portable track MD, NP, OT, PT GEN Yes 1 every 7 years  
99400952 Ceiling lift battery, replacement   GEN Yes 1 every 2 years  
99400950 Ceiling lift, replacement MD, NP, OT, PT GEN Yes 1 every 7 years  
99400951 Ceiling lift, sling, replacement MD, NP, OT, PT GEN Yes 2 every 2 years  
99400324 Hydraulic lift, powered MD, NP, OT, PT GEN Yes 1 every 7 years Justification as to why a standard hydraulic lift will not meet the client's need
99400817 Hydraulic lift, powered, recycled MD, NP, OT, PT GEN Yes 1 every 7 years  
99400325 Hydraulic lift, standard MD, NP, OT, PT GEN Yes 1 every 7 years  
99400816 Hydraulic lift, standard, recycled MD, NP, OT, PT GEN Yes 1 every 7 years  
99400326 Hydraulic lift, sling or hammock replacement MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes 2 every 2 years  
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.7.3 Pole

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400321 Floor to ceiling pole MD, NP, OT, PT GEN No 1 every 10 years
  • floor to ceiling transfer pole without accessories
  • the client's weight must be within the weight capacity of the device

9.7.4 Trapeze

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400329 Trapeze bar and floor stand, purchase MD, NP, OT, PT GEN Yes 1 per lifetime  
99401134 Trapeze bar and floor stand, bariatric, purchase MD, NP, OT, PT GEN Yes 1 per lifetime  
99400330 Trapeze, rental MD, NP, OT, PT GEN Yes   Rented for 1 month at a time

9.7.5 Transfer

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400309 Leg lifter MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
99400327 Transfer belt MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 per year  
99400328 Transfer board MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN No 1 every 10 years  
99400902 Transfer disc MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes    
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.8 Home hospital beds and accessories

For all items, providers must submit the following information for prior approval:

For clients who require a hospital bed and rails, this must be claimed using the code for electric hospital bed with rails: code 99401125 or electric hospital bed with rails – bariatric: code 99401126. The code for hospital bed rails: code 99401384 is not eligible for coverage concurrently with the codes for electric hospital bed: code 99401382 or electric hospital bed – bariatric: code 99401383, unless claiming these items separately is more cost-effective.

9.8.1 Beds and rails

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99401382 Electric hospital bed MD, NP, OT, PT, homecare RN GEN Yes 1 every 7 years
  • provides motorized positioning of upper body and knee
  • package includes frame, headboard, footboard
  • bed has a weight capacity of at least 350 lbs.
  • includes electric hospital beds and long electric hospital beds
99401383 Electric hospital bed - bariatric MD, NP, OT, PT, homecare RN GEN Yes 1 every 7 years
  • provides motorized positioning of upper body and knee
  • package includes frame, headboard, footboard
  • larger size and weight capacity (at least 500 lbs.) than standard electric hospital bed
  • includes bariatric electric hospital beds and long bariatric electric hospital beds
99401125 Electric hospital bed with rails MD, NP, OT, PT, homecare RN GEN Yes 1 every 7 years
  • provides motorized positioning of upper body and knee
  • package includes frame, headboard, footboard and rails
  • bed has a weight capacity of at least 350 lbs.
  • includes electric hospital beds with rails and long electric hospital beds with rails
99401126 Electric hospital bed with rails - bariatric MD, NP, OT, PT, homecare RN GEN Yes 1 every 7 years
  • provides motorized positioning of upper body and knee
  • package includes frame, headboard, footboard
  • larger size and weight capacity (at least 500 lbs.) than standard electric hospital bed
  • includes bariatric electric hospital beds with rails and long electric hospital beds with rails
99401136 Rental – electric hospital bed with rails MD, NP, OT, PT, homecare RN GEN Yes    
99401384 Hospital bed rails (pair) MD, NP, OT, PT, homecare RN GEN Yes 1 every 7 years Rails designed for use with a hospital bed that can be used for bed mobility or repositioning, transfers or to prevent falls from the bed

9.8.2 Mattresses

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99401128 Standard hospital bed mattress MD, NP, OT, PT, homecare RN GEN Yes 1 every 5 years
  • a medical grade mattress designed for use on a hospital bed
  • generally constructed of different densities of foam
  • includes standard bed mattress and long hospital bed mattress
99401130 Pressure relief mattress MD, NP, OT, PT, homecare RN GEN Yes 1 every 5 years
  • a medical grade mattress designed for use on a hospital bed
  • designed to provide higher level of pressure relief for clients at risk of skin breakdown or pressure ulcers
  • constructed of different densities of foam, a combination of foam or gel layers, or foam with gel or static air inserts
  • includes pressure relief mattress and long pressure relief mattress
A pressure relief mattress: code 99401130 and long pressure relief mattress cannot be claimed with non-powered overlay: code 99400314 or a powered overlay: code 99401132.
99401129 Bariatric bed mattress MD, NP, OT, PT, homecare RN GEN Yes 1 every 5 years
  • a medical grade mattress designed for use on a hospital bed
  • generally constructed of different densities of foam
  • larger size and higher weight capacity (at least 500 lbs.) than a standard bed mattress
  • includes bariatric bed mattress and long bariatric bed mattress
99401131 Bariatric pressure relief mattress MD, NP, OT, PT, homecare RN GEN Yes 1 every 5 years
  • a medical grade mattress designed for use on a hospital bed
  • designed to provide higher level of pressure relief for clients at risk of skin breakdown or pressure ulcers
  • constructed of different densities of foam, a combination of foam or gel layers, or foam with gel or static air inserts
  • larger size and higher weight capacity (at least 500 lbs.) than a standard pressure relief mattress
  • includes bariatric pressure relief mattress and long bariatric pressure relief mattress
Bariatric pressure relief mattress and long bariatric pressure relief mattress cannot be claimed with non-powered overlay: code 99400314 or powered overlay: code 99401132.
99401385 Rental – hospital bed mattress MD, NP, OT, PT, homecare RN GEN Yes    

9.8.3 Overlay

  • a pressure-relieving surface designed to be used on top of a mattress
  • if a hospital bed is being used, a pressure relieving mattress should be considered prior to an overlay

Overlays cannot be claimed with pressure relieving mattress: code 99401130 or bariatric pressure relieving mattress: code 99401131.

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400314 Non-powered overlay MD, NP, OT, PT, homecare RN GEN Yes 1 every 5 years A medical grade pressure-relieving surface made of a foam, gel, or compartments inflated with air
99401132 Powered overlay MD, NP, OT, PT, homecare RN GEN Yes 1 every 5 years An inflated medical grade pressure-relieving surface, powered by a motor

9.9 Uncategorized medical supplies

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400765 Electronic blood pressure monitor with arm cuff MD, NP, RM GEN No 1 every 5 years  
99400877 Inspection mirror MD, NP, OT, PT, RN, LPN/RPNTable note 1 GEN Yes 1 per lifetime  
99400471 MedicAlert subscription MD, NP, RN, RRT, LPN/RPNTable note 1 GEN Yes 1 every 5 years  
99401270 Thermometer, oral, digital MD, NP, RN, LPN/RPNTable note 1 GEN No 1 every 5 years  
Table Note 1

The LPN in Saskatchewan cannot recommend this benefit.

Return to table note 1 referrer

9.10 Servicing

9.10.1 Repairs

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99400938 Repair, bath chair lift   GEN Yes    
99400307 Repair, bathing and toileting aid   GEN Yes    
99400954 Repair, ceiling lift motor   GEN Yes    
99401135 Repair, electric hospital bed   GEN Yes   6 month warranty
99400293 Repair, feeding aid   GEN Yes    
99400331 Repair, lifting or transfer aids   GEN Yes    

9.10.2 Delivery

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99401137 Delivery, electric hospital bed or mattress   GEN Yes   Way bills must be provided
99400930 Delivery, gender identity   GEN No    
99401266 Delivery, self-care   GEN Yes    

9.10.3 Installation

Item code Item name Prescriber Provider Prior approval required Recommended replacement guidelines Additional details
99401381 Installation – electric hospital bed or mattress   GEN Yes    

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