Important guidelines for avoiding common billing errors in DME claims

Through our claims research, we have identified a common billing error related to DME items that can be rented or purchased. We are advising you on this issue to ensure that future claims are accepted and approved, have smoother claims processing, and have timely and accurate reimbursement for your services. This error can be avoided by adhering to the modifier usage requirements outlined below:

• Use the RR modifier for all rental codes.
• Use the NU modifier for codes that are purchased but could also be a rental.
• Equipment that cannot be billed as a rental does not require a NU modifier.

Note, rentals must be billed as one unit per month with dates of service spanning the entire month. For example, bill one unit with dates of service from January 1 to January 31, 2025. Additionally, claim lines should not span across multiple months.

Additional resources:

• Reference Virginia Department of Medical Assistance Services (DMAS) guidelines for up‑to‑date allowed amounts and billing requirements for various categories.
• Review the Virginia Department of Medical Assistance Services (DMAS) Durable Medical Equipment (DME) Appendix B 21 Excel Version With All Categories Of Appendix B July 2024 fee schedule.

Thank you for your continued partnership. If you have questions or concerns, contact Provider Services at 800‑901‑0020.