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How to Write a Letter of Medical Necessity
By Rebecca Miller, BA, LPN
When caring for your child with special needs, you may be asked to provide a Letter of Medical Necessity to receive different services or equipment. The Letter of Medical Necessity or LMN outlines the medical justification for a specific medical treatment, procedure, or equipment that is not considered standard or routine. The LMN is used to prove that a particular medical intervention, such as a service or medical equipment, is essential for the well-being of a patient and should be covered or reimbursed by insurance or Medicaid benefits.
Your pediatrician writes this letter, but most information comes from you. Your information about your child may make or break the argument of why the services or equipment are necessary.
For instance, you may want a Cubby Bed for your child who gets up at night and tries to open the front door and go outside. If you express desire as a benefit–I would like this bed because it will keep him safe– you may get less of an agreement than when you present actual evidence. These can be statements of diagnosis and other comorbidities–other health or behavioral issues, history of elopement, average hours of sleep a night for both parent and child, any police encounters, how long this behavior has been occurring, frequency of nocturnal awakenings–you get the picture…
