Wiki DME Units

[hawaii50007@gmail.com]

Hello All,

I have a question for the group... How are service units determined for DME? I am looking at the CMS website and found an MUE table for the ceiling and floor prices for certain codes however nothing explicitly talking about how to calculate service units for a code, maximum amount of service units for a code, etc. My understanding of DME units is that the provider bills for the amount of days that they expect the member to need the equipment unless otherwise specified. For example, wheelchair use would be billed per day so if the member needed it all year long, the provider would bill 365 for units to cover the year. Am I on the correct track?

 

[CodingKing]

Very few items are per day such as Wound Vac, Continuous Passive Motion (CPM) & pressure reducing matresses/bedding. Most other Rentals (RR Mod) are by 30 day period so 1 unit for the first day of each rental month. You would never bill for more than a month at a time. It goes until the monthly rental cap at which the patient owns the equipment. Payer may allow as a purchase up front for some lesser expensive items.

There's a whole bunch of information in the DME section of the Medicare Claims Processing Manual

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c20.pdf