As health care continues to shift toward home-based care, the need for pediatric home medical equipment (HME) services is rapidly increasing. The shared goal is to keep pediatric patients safely at home and out of the hospital whenever possible. For providers, this growing category offers significant opportunities—but also added complexity if just starting out. Pediatric patients require specialized clinical and staff support, a diverse product portfolio and a thorough understanding of additional reimbursement nuances. Despite the initial challenges, the advantages of pediatric expansion are clear, with long-term rewards that significantly outweigh the risks.
Reimbursement Challenges
One of the most persistent challenges in pediatric HME is navigating reimbursement. Because Medicaid, which typically operates under a fee-for-service model, is the primary payer for pediatric patients, providers are reimbursed per covered service. Pediatric billing codes can be more complex than adult equivalents, especially when custom equipment or specialized therapies are involved. This puts additional pressure on billing departments to be well-informed. Although these obstacles exist, venturing into pediatric services can help diversify your revenue stream. When managed effectively, pediatric reimbursement brings greater financial stability and helps offset fluctuations in adult services.
To address these challenges, many providers have established pediatric-specific billing teams or implemented software to flag documentation issues before claims are submitted. Partnering closely with referral sources to obtain complete clinical documentation upfront significantly reduces delays and denials. Adding to this complexity, staffing can present its own set of challenges.
Operational & Labor Challenges
Finding and retaining employees with pediatric experience, whether clinical, technical or administrative, is increasingly difficult in today’s competitive labor market. For many organizations, success relies not only on strong systems and processes but also on building a team with the skills and commitment to support these vulnerable patients. Not all service technicians are trained for or comfortable working with children, especially when it comes to pediatric-specific equipment.
Providers have created specialized pediatric service teams or implemented targeted training programs. Others have invested in regional equipment hubs or mobile service units to enhance responsiveness and minimize equipment downtime. If providers are looking to start up a pediatric division, cross-training staff to manage both adult and pediatric populations is a strategic approach. Once volume grows, hiring pediatric specialists can provide needed flexibility. While these strategies may require upfront investment, they can lead to greater patient satisfaction and improved outcomes in the long run.
To support sustainable growth in this space, operational strategies must also be a focus. Gradual rollouts, starting with high-demand items, help mitigate financial risk while building internal confidence and capacity. Additionally, developing a direct-to-patient shipping program helps reduce the cost and burden of home deliveries, making supply fulfillment more efficient for both providers and families. Establishing strong relationships with HME manufacturers that provide pediatric-specific support and education further enhances equipment purchasing and rentals. Many manufacturers and vendors have invested time and effort into designing products that prioritize safety and comfort for children, offering peace of mind for parents and providing advantageous costs to providers.
Liability Concerns
Caring for pediatric patients brings higher levels of risk and increased liability concerns. Even minor errors in equipment setup or caregiver instruction can result in serious consequences. This is why thorough documentation is critical not only for reimbursement, but also as the first line of defense of legal protection. Maintaining detailed records of equipment setup, caregiver training and follow-up interactions go a long way in showing the team is doing its due diligence. Some providers have found success with quarterly pediatric case reviews to make sure everything’s in line with clinical and legal standards. Others have implemented internal systems to flag potential safety concerns early before they become bigger issues.
Patient & Family Education
Pediatric care is collaborative, involving not just the patient and provider but also parents, caregivers, schools and sometimes multiple specialists. For HME providers, this means delivering training and support that goes well beyond the basics. Families need to feel confident managing complex equipment like ventilators, feeding pumps or mobility aids in their daily routines. Unlike adult patients, children are constantly growing and developing, which means their equipment needs will evolve over time. At the same time, providers need to be mindful of the emotional toll families may be carrying, especially when navigating chronic or life-limiting conditions.
Structured onboarding programs can make a big difference. Offering in-home education, caregiver checklists and follow-up calls can help improve outcomes, prevent unnecessary hospital readmissions and reduce risk of complications. Telehealth has become a popular tool in the HME world now that virtual visits are reimbursable. This opens the door for families to schedule last-minute check-ins troubleshooting sessions or follow-up appointments without needing to travel to a clinic. Advancing technology allows providers to quickly address concerns, reinforce training or assess equipment use in real-time, all from the comfort of the family’s home. These methods can extend support, improve continuity of care and create a layer of safety for both patients and caregivers.
Benefits of Adding Pediatric Lines
While these challenges persist, pediatric providers that have dedicated themselves to their business and customer base have seen the benefits of their hard work spanning many years.
“PromptCare's success in the pediatric space begins with a strong commitment to patient care,” said PromptCare’s Gary Terrebush. “The compassion and expertise of both our clinical and non-clinical staff are key drivers of our business's success. Additionally, the right business partners play a crucial role in helping us offer quality products at a cost-effective rate, enabling us to continue delivering the highest level of care for our most fragile of patients.”
Expanding into pediatric services can offer several strategic benefits. For starters, it opens the door to creating long-term relationships with families, often lasting for years as the child grows and their needs evolve. Because pediatric care tends to be continuous, it can lead to recurring revenue and high customer retention. This can be especially beneficial for smaller HME providers who are looking to diversify and grow in a strategic way. Focusing on pediatrics allows them to carve out a place in a market that values personalized service and strong relationships. By thoughtfully laying the groundwork, they can gradually expand their pediatric offering starting with high-demand items like ventilators, wheelchairs, phototherapy units and enteral feeding pumps and supplies.
Offering pediatric services also sets HME providers apart by appealing to referral sources in a competitive market. Servicing and caring for both adult and pediatric patients make a provider more valuable and attractive to referral sources. This not only strengthens provider-physician relationships, but can also lead to an increase in referrals, broader market share and stronger relationships with payers.
In Conclusion
Pediatrics may come with added complexity, but the rewards can be long-lasting for HME providers willing to invest the time, training and intention. From building deep relationships with families to creating a more diversified business, expanding into pediatric care opens the door to impactful and sustainable growth. By focusing on strong clinical practices, thoughtful onboarding and operational scalability, providers can deliver the kind of service that truly sets them apart. As the health care landscape continues to shift toward home-based care, pediatric HME isn’t just a growth opportunity, it’s a chance to make a difference where it matters most.