Letters of Medical Necessity for Adaptive Equipment

A letter of medical necessity can help explain why a specific adaptive product, therapy tool, mobility device, safety product, or special needs equipment item is needed for an individual’s daily care, safety, mobility, positioning, communication, sensory support, or functional independence.

At eSpecial Needs, we understand that families, therapists, schools, clinics, and caregivers may need supporting documentation when requesting funding through insurance, Medicaid, waiver programs, grants, school districts, or other third-party funding sources. While eSpecial Needs cannot write clinical letters or guarantee reimbursement, this resource can help you understand what information is commonly included in a strong letter of medical necessity.

What Is a Letter of Medical Necessity?

A letter of medical necessity is a written statement, usually prepared by a licensed healthcare provider, therapist, physician, or other qualified professional, that explains why a product or service is medically or functionally necessary for a specific person.

For adaptive equipment and special needs products, this type of letter may help describe:

• The individual’s diagnosis, condition, disability, or functional limitation
  
• The specific product or equipment being requested
  
• How the equipment supports safety, mobility, positioning, therapy, communication, sensory regulation, or daily living
  
• Why the requested item is appropriate for the individual’s needs
  
• What may happen if the equipment is not provided
  
• Why less supportive or lower-cost alternatives may not meet the person’s needs