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SWO Standard Written Order — required for every DMEPOS itemStandard Written Order (SWO) requirements for Medicare DME
Citations verified against the CMS Medicare Coverage Database · Reviewed September 2026
The Standard Written Order (SWO) is the single order format Medicare has required for all DMEPOS items since January 1, 2020, when CMS-1713-F replaced the older detailed written order and the various five-element and seven-element formats with one list of elements in 42 CFR 410.38(d). The Certificate of Medical Necessity (CMN) and DME Information Form (DIF) were discontinued separately, for dates of service on or after January 1, 2023.
This guide lists the elements a reviewer checks, the timing rules for when the order has to exist, and the handful of details — who may prepare it, what is no longer required — that still trip up otherwise complete files.
The requirements, with citations
The elements below are drawn from the cited CMS and DME MAC sources, not from AffirmDME's rules engine.
Beneficiary name or Medicare Beneficiary Identifier (MBI)
Either identifies the patient. Reviewers match it against the claim and the clinical record, so the spelling and the MBI need to agree with what is on the Medicare card.
42 CFR 410.38(d); Article A55426Order date
The date the order was written anchors two other clocks: the face-to-face encounter must fall within the six months before it for items on the face-to-face list, and for those same items the order must reach the supplier before delivery. An undated order cannot satisfy either rule.
42 CFR 410.38(d)General description of the item, and quantity if applicable
The description has to be clear enough for a reviewer to match it to the HCPCS code billed. Quantity is required when it applies, such as supplies. Frequency of use and length of need are no longer SWO elements — see below.
Article A55426 — Standard Written OrderTreating practitioner name or NPI
Either the practitioner's name or National Provider Identifier is acceptable, but the practitioner must be the one treating the beneficiary. Under 410.38 a treating practitioner is a physician, physician assistant, nurse practitioner, or clinical nurse specialist.
42 CFR 410.38(a), (d)Treating practitioner signature
For items other than power mobility devices, someone else may complete the other elements — a supplier can prepare the order — but the treating practitioner must sign it. For power mobility devices, the practitioner who performed the face-to-face encounter must complete the order.
Article A55426; Noridian SWO FAQ (CMS-1713-F)On file before the claim; before delivery for listed items
For every DMEPOS item the SWO must be communicated to the supplier before the claim is submitted. For items on CMS's Required Face-to-Face Encounter and Written Order Prior to Delivery List (power mobility devices and other selected items), the order must be in the supplier's hands before the item is delivered.
42 CFR 410.38(d); Article A55426Length of need is no longer an order element
The 2020 rule dropped length of need and frequency from the order itself, and Article A55426 does not list them. Some coverage policies still expect the medical record to address the expected duration of need for rental items, so check the item's LCD and policy article rather than adding elements to the order that no longer belong there.
Noridian SWO FAQ (CMS-1713-F)What usually sinks these claims
- The order is signed but not dated, or the order date falls after delivery on an item that required a written order prior to delivery
- A signature is present but no practitioner name or NPI ties it to a specific treating practitioner
- A supplier-prepared order went to the office for signature and never came back, and the claim was filed on the verbal order
- The description on the order does not match the HCPCS billed — the order says “wheelchair” and the claim bills a power wheelchair
- A CMN or DIF form is still being used as the order for dates of service in 2023 or later
Get the order signed without the fax chase
AffirmDME sends the SWO to the prescriber for e-signature through DocuSign, follows up by fax when the office is slow, and flags an unsigned or undated order on the readiness checklist before the case goes out.
See SWO e-signatureFAQ
What changed with the Standard Written Order in 2020?
CMS-1713-F consolidated the older detailed written order, five-element order, and seven-element order into one format with six elements, effective January 1, 2020. It also moved the face-to-face requirement for power mobility devices from 45 days to six months and created the Master List that feeds the face-to-face and prior authorization lists.
Do I still need a Certificate of Medical Necessity?
No. CMS discontinued CMNs and DIFs for claims with dates of service on or after January 1, 2023, and claims that include CMN or DIF information are rejected. The SWO plus the medical record carry the information those forms used to carry.
Can the supplier fill out the SWO for the practitioner to sign?
For items other than power mobility devices, yes — Article A55426 allows someone other than the treating practitioner to complete elements of the SWO as long as the treating practitioner signs it. For power mobility devices the practitioner who did the face-to-face encounter must complete the order.
Can AffirmDME get the SWO signed?
Yes. AffirmDME sends the order to the prescriber for e-signature through DocuSign and can follow up with the office by fax. Its missing-document detection flags an unsigned, undated, or incomplete order on the case before you submit.
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This guide summarizes Medicare requirements as implemented in AffirmDME's compliance engine, with citations to the governing sources. It is not legal or billing advice; LCDs and CMS policy change — always confirm against the current policy text linked above.
Also drawn on: CMS SE22002 — elimination of CMNs and DIFs .
More guides
- Medicare ADR Letters: how to respond without losing the claim
- Medicare DME Documentation Requirements: the checklist every claim needs
- Medicare CPAP Documentation Requirements (E0601)
- Medicare Home Oxygen Documentation Requirements (E1390)
- Medicare BiPAP / RAD Documentation Requirements (E0470)
- Medicare Hospital Bed Documentation Requirements (E0260)
- Medicare Wheelchair & Power Mobility Prior Authorization (E1161)
- Medicare Knee Orthosis Documentation Requirements (L1833, L1832)
- Medicare TLSO Documentation Requirements (L0456, L0457, L0486)
- Medicare Air-Fluidized Bed Documentation Requirements (E0194)
- Medicare Ultralightweight Manual Wheelchair Requirements (K0005)
- Medicare Upper Limb Orthosis Requirements (L3761, L3916)
- Medicare Osteogenesis Stimulator Documentation Requirements (E0747, E0748)
- The Medicare DMEPOS Required Prior Authorization List, explained (2026)
- Probationary Prior Authorization for newly enrolled DMEPOS suppliers (Oct 15, 2026)
- The DMEPOS prior authorization exemption: how it works and how to keep it
- Which DME MAC handles your claim: Jurisdictions A, B, C, and D
- Medicare DME face-to-face encounter requirements
- Prior authorization vs ADR vs prepayment review vs TPE: what each means for a DME claim
- After a non-affirmed prior authorization: resubmit, deliver with an ABN, or wait
- Medicare DME proof of delivery requirements
- Preparing and submitting a DMEPOS prior authorization request
Unfamiliar term? The glossary defines ADR, SWO, UTN, PTAN and the rest; the PA List lookup checks any HCPCS code.