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Home Health & Hospice Week

Capped Rentals:

HEED NEW HME BILLING GUIDANCE

Published on Thu Feb 08, 2007

Don't let mistakes on capped rental claims sap your bottom line.

New guidance from the feds aims to help suppliers grasp Medicare billing requirements for capped rental home medical equipment. Keep these highlights in mind to keep claims on track:

• Maintenance for most capped rental items. Medicare contractors will no longer pay every six months for maintenance and servicing (M&S), but the program will cover "reasonable and necessary" repairs after the beneficiary holds the title.

• Maintenance for oxygen equipment. Medicare will pay for M&S every six months, starting six months after the beneficiary owns the equipment. Contractors will make M&S payments in 15-minute intervals, not to exceed 30 minutes. In addition, Medi-care will cover reasonable and necessary repairs.

Tip: To ensure payment for such claims, use the base HCPCS code for the oxygen equipment with the "MS" modifier for maintenance and servicing.

Maintenance and servicing claims for oxygen equipment should not exceed two units (of E1340) every six months.

• Replacement parts. Use the modifier "RP" to bill for replacement parts. If a specific replacement code is not available for billing, use HCPCS code E1399 with the "RP" modifier.

Note: To see the guidance in MLN Matters article 5461, go to www.cms.hhs.gov/MLNMattersArticles/downloads/MM5461.pdf.
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