Maintenance - JA DME

DME

Routine periodic servicing, such as testing, cleaning, regulating, and checking of the beneficiary's DME, is not covered. The beneficiary is expected to perform such routine maintenance rather than the supplier or some other person who charges the beneficiary. Normally, purchasers of DME are given operating manuals which describe the type of servicing an owner may perform to properly maintain the equipment. It is reasonable to expect that beneficiaries will perform this maintenance. Thus, hiring a third party to do such work is for the convenience of the beneficiary and is not covered.

However, more extensive maintenance which, based on the manufacturers' recommendations, is to be performed by authorized technicians, and is covered as repairs for medically necessary DME which a beneficiary owns. This might include, for example, breaking down sealed components and performing tests which require specialized testing equipment not available to the beneficiary.

Maintenance of purchased items that require frequent and substantial servicing is not covered.

Oxygen

In the initial 36-month rental period for oxygen, there is no separate payment for maintenance. The supplier who provides the equipment during the 36th rental month is required to continue to provide the equipment, accessories, contents (if applicable), maintenance, and repair of the oxygen equipment during the five-year reasonable useful lifetime of the equipment. If a beneficiary was using a stationary concentrator, portable concentrator, or trans-filling equipment during the 36th rental month, Medicare will pay for maintenance and service (MS) visit no more often than every six months, beginning no sooner than six months following the end of the rental period. If the equipment is covered under a warranty that covers labor related to routine/general maintenance and servicing (e.g., inspection, changing filters, cleaning, and calibration), payment for the first MS visit can be no sooner than six months following the end of that warranty.

A supplier must actually make a visit to bill the service. If multiple MS visits are made during a six-month period, only one will be paid.

There is no MS payment for gaseous or liquid equipment.

Modifier

MS - Add to claim line to indicate a six-month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty.