Can Positional Therapy Pillow Co. products be covered by my Special Disability or Medicaid coverage?

Two basic requirements are necessary:
1) A Letter of Medical Necessity; and
2) A prescription from a doctor specifying the specific bed model.

About Letters of Necessity:

In a letter of medical necessity, it must be clear that a Positional Therapy Pillow product addresses special needs that our product specifically provides. The key is to emphasize the clinical needs of the patient. It must be pointed out how his or her needs are not being met by his or her current treatment and pillow/mattress. Once the shortcomings of the current bed have been detailed, a Positional Therapy Pillow product can be prescribed in answer to the particular needs.

A Basic Outline for a Letter of Necessity

1. Introduce the patient and how long she or he has been in the care of the doctor or facility. Describe his or her condition and detail the special needs that are a consequence of the condition (i.e. lack of sleep; inability to maintain semi-upright position on wedge pillow or inclined bed; the need to be in a semi-upright position to avoid choking, sore throat, tooth decay; a child's lack of control in using a wedge pillow designed for an adult).

2. Recommend the Positional Therapy Pillow product that addresses each of the concerns-with specific requirements such as lumbar support, recessed shoulder rests to increase breathing capacity, the ability to side sleep, or the inability of a child to roll over the side-wedges while sleeping.

3. The imperative that the specific needs be addressed, and prescribe the appropriate model.

About Medicaid - Use HCPCS code Miscellaneous Code E1399

Can Positional Therapy Pillow Co. products be covered by my personal insurance?

Each insurance plan is different. Depending upon the type of plan you have purchased, you may be able to obtain a pillow through your insurance. We are happy to work with any insurance provider. Most insurance companies have two basic requirements:

1) A Letter of Medical Necessity; and
2) A prescription from a doctor specifying the specific product model.

About Letters of Necessity:

In a letter of medical necessity, it must be clear that a Positional Therapy Pillow product addresses special needs that our product specifically provides. The key is to emphasize the clinical needs of the patient. It must be pointed out how his or her needs are not being met by his or her current treatment and pillow/mattress. Once the shortcomings of the current bed have been detailed, a Positional Therapy Pillow product can be prescribed in answer to the particular needs.

A Basic Outline for a Letter of Necessity

1. Introduce the patient and how long she or he has been in the care of the doctor or facility. Describe his or her condition and detail the special needs that are a consequence of the condition (i.e. lack of sleep; inability to maintain semi-upright position on wedge pillow or inclined bed; the need to be in a semi-upright position to avoid choking, sore throat, tooth decay; a child's lack of control in using a wedge pillow designed for an adult).

2. Recommend the Positional Therapy Pillow product that addresses each of the concerns-with specific requirements such as lumbar support, recessed shoulder rests to increase breathing capacity, the ability to side sleep, or the inability of a child to roll over the side-wedges while sleeping.

3. The imperative that the specific needs be addressed, and prescribe the appropriate model.

Use HCPCS code Miscellaneous Code E1399

We are now a Tricare provider for durable medical pillows. Please contact us for information about filing for benefits.

Affiliate Programs

We are currently in the process of establishing an affiliate program. Please contact us directly for more information. For special needs patients, a letter of necessity is provided above.

We appreciate the opportunity to work with you and it is our pleasure to work through the order process with you. Please feel free to call us if we can be of any assistance at 361-767-1888 from 9 a.m. to 9 p.m. CST.