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View ESA-OWCP-DCMWC's Form 1215-0113 Online 
| Agency: |
ESA-OWCP-DCMWC |
| Title: |
CM-893, Certificate of Medical Necessity |
| Form Description: |
CM-893, Certificate of Medical Necessity: The CM-893 form is a prescription for durable medical equipment, for home nursing care, or for pulmonary rehabilitation services and is completed by the medical provider. All required objective testing must be included. |
| OMB Control Number: |
1215-0113 |
| OMB Expiration Date: |
Wednesday, December 31, 2008
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