DME Order Forms

Below you will find the HCPCS Code List that is effective January 1, 2024, and a description of the revisions effective for Calendar Year 2024.

The Healthcare Common Procedure Coding System (HCPCS) is a collection of standardized codes that represent medical procedures, supplies, products, and services. These codes are used in the billing and processing of health insurance claims with Medicare, Medicaid, and other insurers.

HCPCS codes are used to:

• Report hospital outpatient procedures

• Report physician services

• Support physician reimbursement

• Support hospital payments

• Support quality review

• Support benchmarking measurement

• Collect general medical statistical data

HCPCS codes include two medical code sets, HCPCS Level I and HCPCS Level II:

• Level I: Represents procedures, supplies, products, and services

• Level II: Represents non-physician services, such as:

  • Ambulance rides

  • Wheelchairs

  • Walkers

  • Other durable medical equipment

  • Other medical services that don't fit readily into Level I

You can contact Customer Service to provide you an RFP

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Medicare Part B (Medical Insurance) covers medically necessary DME when a Medicare-enrolled doctor or other health care provider orders it for use in your home. DME that Medicare covers includes, but isn't limited to:

• Blood sugar meters

• Blood sugar test strips

• Canes

• Commode chairs

• Continuous passive motion devices

• Continuous Positive Airway Pressure (CPAP) devices

• Crutches

• Hospital beds

• Home infusion services

• Infusion pumps & supplies

• Lancet devices & lancets

• Nebulizers & nebulizer medications

• Oxygen equipment & accessories

• Patient lifts

• Pressure-reducing support surfaces

• Suction pumps

• Traction equipment

• Walkers

• Wheelchairs & scooters

Your costs in the Original MedicareAfter you meet the Part B Deductible, you pay 20% of the Medicare-Approved Amount (if your supplier accepts the assignment). Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:

• You may need to rent the equipment.

• You may need to buy the equipment.

• You may be able to choose whether to rent or buy the equipment.

Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims they submit.

Make sure your doctors and DME suppliers are enrolled in Medicare. It’s also important to ask a supplier if they participate in Medicare before you get DME. If suppliers are participating in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare‑approved amount). If suppliers aren’t participating and don’t accept assignments, there’s no limit on the amount they can charge you.