2019 Jurisdiction List - JA DME
2019 Jurisdiction List
NOTE: Deleted codes are valid for dates of service on or before the date of deletion.
NOTE: Updated codes are in bold.
NOTE: The jurisdiction list includes codes that are not payable by Medicare. Please consult the Medicare contractor in whose jurisdiction a claim would be filed in order to determine coverage under Medicare.
NOTE: All Local Carrier language has been changed to Part B MAC
SEARCH TIP: Enter only the first two or three digits of the HCPCS code in the search box to display range of codes, then scroll down page to find specific code.
| HCPCS | DESCRIPTION | JURISDICTION |
|---|---|---|
| A0021 - A0999 | Ambulance Services | Part B MAC |
| A4206 - A4209 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4210 | Needle Free Injection Device | DME MAC |
| A4211 | Medical, Surgical, and Self- Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4212 | Non Coring Needle or Stylet with or without Catheter | Part B MAC |
| A4213 - A4215 | Medical , Surgical, and Self- Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4216 - A4218 | Saline | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4220 | Refill Kit for Implantable Pump | Part B MAC |
| A4221 - A4236 | Self-Administered Injection and Diabetic Supplies | DME MAC |
| A4244 - A4250 | Medical, Surgical, and Self- Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4252 - A4259 | Diabetic Supplies | DME MAC |
| A4261 | Cervical Cap for Contraceptive Use | Part B MAC |
| A4262 - A4263 | Lacrimal Duct Implants | Part B MAC |
| A4264 | Contraceptive Implant | Part B MAC |
| A4265 | Paraffin | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4266 - A4269 | Contraceptives | Part B MAC |
| A4270 | Endoscope Sheath | Part B MAC |
| A4280 | Accessory for Breast Prosthesis | DME MAC |
| A4281 - A4286 | Accessory for Breast Pump | DME MAC |
| A4290 | Sacral Nerve Stimulation Test Lead | Part B MAC |
| A4300 - A4301 | Implantable Catheter | Part B MAC |
| A4305 - A4306 | Disposable Drug Delivery System | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4310 - A4358 | Incontinence Supplies/ Urinary Supplies | If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
| A4360 - A4435 | Urinary Supplies | If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
| A4450 - A4456 | Tape; Adhesive Remover | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. |
| A4458 - A4459 | Enema Bag/System | DME MAC |
| A4461 - A4463 | Surgical Dressing Holders | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4465 - A4467 | Non-elastic Binder and Garment, Strap, Covering | DME MAC |
| A4470 | Gravlee Jet Washer | Part B MAC |
| A4480 | Vabra Aspirator | Part B MAC |
| A4481 | Tracheostomy Supply | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4483 | Moisture Exchanger | DME MAC |
| A4490 - A4510 | Surgical Stockings | DME MAC |
| A4520 | Diapers | DME MAC |
| A4550 | Surgical Trays | Part B MAC |
| A4553 - A4554 | Underpads | DME MAC |
| A4555 - A4558 | Electrodes; Lead Wires; Con- ductive Paste | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4559 | Coupling Gel | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4561 - A4563 | Pessary; Vaginal Insert | Part B MAC |
| A4565 - A4566 | Sling | Part B MAC |
| A4570 | Splint | Part B MAC |
| A4575 | Topical Hyperbaric Oxygen Chamber, Disposable | DME MAC |
| A4580 - A4590 | Casting Supplies & Material | Part B MAC |
| A4595 | TENS Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4600 | Sleeve for Intermittent Limb Compression Device | DME MAC |
| A4601 - A4602 | Lithium Replacement Batteries | DME MAC |
| A4604 | Tubing for Positive Airway Pressure Device | DME MAC |
| A4605 | Tracheal Suction Catheter | DME MAC |
| A4606 | Oxygen Probe for Oximeter | DME MAC |
| A4608 | Transtracheal Oxygen Catheter | DME MAC |
| A4611 - A4613 | Oxygen Equipment Batteries and Supplies | DME MAC |
| A4614 | Peak Flow Rate Meter | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4615 - A4629 | Oxygen & Tracheostomy Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
| A4630 - A4640 | DME Supplies | DME MAC |
| A4641 - A4642 | Imaging Agent; Contrast Material | Part B MAC |
| A4648 | Tissue Marker, Implanted | Part B MAC |
| A4649 | Miscellaneous Surgical Supplies | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A4650 | Implantable Radiation Dosimeter | Part B MAC |
| A4651 - A4932 | Supplies for ESRD | DME MAC (not separately payable) |
| A5051 - A5093 | Additional Ostomy Supplies | If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
| A5102 - A5200 | Additional Incontinence and Ostomy Supplies | If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
| A5500 - A5514 | Therapeutic Shoes | DME MAC |
| A6000 | Non-Contact Wound Warming Cover | DME MAC |
| A6010 - A6024 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A6025 | Silicone Gel Sheet | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A6154 - A6411 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A6412 | Eye Patch | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A6413 | Adhesive Bandage | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A6441 - A6457 | Surgical Dressings | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
| A6460 - A6461 | Surgical Dressing | Part B MAC |
| A6501 - A6512 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC |
| A6513 | Compression Burn Mask | DME MAC |
| A6530 - A6549 | Compression Gradient Stockings | DME MAC |
| A6550 | Supplies for Negative Pressure Wound Therapy Electrical Pump | DME MAC |
| A7000 - A7002 | Accessories for Suction Pumps | DME MAC |
| A7003 - A7039 | Accessories for Nebulizers, Aspirators and Ventilators | DME MAC |
| A7040 - A7041 | Chest Drainage Supplies | Part B MAC |
| A7044 - A7047 | Respiratory Accessories | DME MAC |
| A7048 | Vacuum Drainage Supply | Part B MAC |
| A7501 - A7527 | Tracheostomy Supplies | DME MAC |
| A8000 - A8004 | Protective Helmets | DME MAC |
| A9150 | Non-Prescription Drugs | Part B MAC |
| A9152 - A9153 | Vitamins | Part B MAC |
| A9155 | Artificial Saliva | Part B MAC |
| A9180 | Lice Infestation Treatment | Part B MAC |
| A9270 | Noncovered Items or Services | DME MAC |
| A9272 | Disposable Wound Suction Pump | DME MAC |
| A9273 | Hot Water Bottles, Ice Caps or Collars, and Heat and/or Cold | DME MAC |
| A9274 - A9278 | Glucose Monitoring | DME MAC |
| A9279 | Monitoring Feature/Device | DME MAC |
| A9280 | Alarm Device | DME MAC |
| A9281 | Reaching/Grabbing Device | DME MAC |
| A9282 | Wig | DME MAC |
| A9283 | Foot Off Loading Device | DME MAC |
| A9284- A9286 | Non-electric Spirometer, Inversion Devices and Hygienic Items | DME MAC |
| A9300 | Exercise Equipment | DME MAC |
| A9500 - A9700 | Supplies for Radiology Procedures | Part B MAC |
| A9900 | Miscellaneous DME Supply or Accessory | Part B MAC if used with implanted DME. If other, DME MAC. |
| A9901 | Delivery | DME MAC |
| A9999 | Miscellaneous DME Supply or Accessory | Part B MAC if used with implanted DME. If other, DME MAC. |
| B4034 - B9999 | Enteral and Parenteral Therapy | DME MAC |
| D0120 - D9999 | Dental Procedures | Part B MAC |
| E0100 - E0105 | Canes | DME MAC |
| E0110 - E0118 | Crutches | DME MAC |
| E0130 - E0159 | Walkers | DME MAC |
| E0160 - E0175 | Commodes | DME MAC |
| E0181 - E0199 | Decubitus Care Equipment | DME MAC |
| E0200 - E0239 | Heat/Cold Applications | DME MAC |
| E0240 - E0248 | Bath and Toilet Aids | DME MAC |
| E0249 | Pad for Heating Unit | DME MAC |
| E0250 - E0304 | Hospital Beds | DME MAC |
| E0305 - E0326 | Hospital Bed Accessories | DME MAC |
| E0328 - E0329 | Pediatric Hospital Beds | DME MAC |
| E0350 - E0352 | Electronic Bowel Irrigation System | DME MAC |
| E0370 | Heel Pad | DME MAC |
| E0371 - E0373 | Decubitus Care Equipment | DME MAC |
| E0424 - E0484 | Oxygen and Related Respiratory Equipment | DME MAC |
| E0485 - E0486 | Oral Device to Reduce Airway Collapsibility | DME MAC |
| E0487 | Electric Spirometer | DME MAC |
| E0500 | IPPB Machine | DME MAC |
| E0550 - E0585 | Compressors/Nebulizers | DME MAC |
| E0600 | Suction Pump | DME MAC |
| E0601 | CPAP Device | DME MAC |
| E0602 - E0604 | Breast Pump | DME MAC |
| E0605 | Vaporizer | DME MAC |
| E0606 | Drainage Board | DME MAC |
| E0607 | Home Blood Glucose Monitor | DME MAC |
| E0610 - E0615 | Pacemaker Monitor | DME MAC |
| E0616 | Implantable Cardiac Event Recorder | Part B MAC |
| E0617 | External Defibrillator | DME MAC |
| E0618 - E0619 | Apnea Monitor | DME MAC |
| E0620 | Skin Piercing Device | DME MAC |
| E0621 - E0636 | Patient Lifts | DME MAC |
| E0637 - E0642 | Standing Devices/Lifts | DME MAC |
| E0650 - E0676 | Pneumatic Compressor and Appliances | DME MAC |
| E0691 - E0694 | Ultraviolet Light Therapy Systems | DME MAC |
| E0700 | Safety Equipment | DME MAC |
| E0705 | Transfer Board | DME MAC |
| E0710 | Restraints | DME MAC |
| E0720 - E0745 | Electrical Nerve Stimulators | DME MAC |
| E0746 | EMG Device | Part B MAC |
| E0747 - E0748 | Osteogenic Stimulators | DME MAC |
| E0749 | Implantable Osteogenic Stimulators | Part B MAC |
| E0755- E0770 | Stimulation Devices | DME MAC |
| E0776 | IV Pole | DME MAC |
| E0779 - E0780 | External Infusion Pumps | DME MAC |
| E0781 | Ambulatory Infusion Pump | DME MAC |
| E0782 - E0783 | Infusion Pumps, Implantable | Part B MAC |
| E0784 | Infusion Pumps, Insulin | DME MAC |
| E0785 - E0786 | Implantable Infusion Pump Catheter | Part B MAC |
| E0791 | Parenteral Infusion Pump | DME MAC |
| E0830 | Ambulatory Traction Device | DME MAC |
| E0840 - E0900 | Traction Equipment | DME MAC |
| E0910 - E0930 | Trapeze/Fracture Frame | DME MAC |
| E0935 - E0936 | Passive Motion Exercise Device | DME MAC |
| E0940 | Trapeze Equipment | DME MAC |
| E0941 | Traction Equipment | DME MAC |
| E0942 - E0945 | Orthopedic Devices | DME MAC |
| E0946 - E0948 | Fracture Frame | DME MAC |
| E0950 - E1298 | Wheelchairs | DME MAC |
| E1300 - E1310 | Whirlpool Equipment | DME MAC |
| E1352 - E1392 | Additional Oxygen Related Equipment | DME MAC |
| E1399 | Miscellaneous DME | Part B MAC if implanted DME. If other, DME MAC. |
| E1405 - E1406 | Additional Oxygen Equipment | DME MAC |
| E1500 - E1699 | Artificial Kidney Machines and Accessories | DME MAC (not separately payable) |
| E1700 - E1702 | TMJ Device and Supplies | DME MAC |
| E1800 - E1841 | Dynamic Flexion Devices | DME MAC |
| E1902 | Communication Board | DME MAC |
| E2000 | Gastric Suction Pump | DME MAC |
| E2100 - E2101 | Blood Glucose Monitors with Special Features | DME MAC |
| E2120 | Pulse Generator for Tympanic Treatment of Inner Ear | DME MAC |
| E2201 - E2397 | Wheelchair Accessories | DME MAC |
| E2402 | Negative Pressure Wound Therapy Pump | DME MAC |
| E2500 - E2599 | Speech Generating Device | DME MAC |
| E2601 - E2633 | Wheelchair Cushions and Accessories | DME MAC |
| E8000 - E8002 | Gait Trainers | DME MAC |
| G0008 - G0067 | Misc. Professional Services | Part B MAC |
| G0068 - G0070 | Infusion Drug Professional Servic | DME MAC |
| G0071 - G0329 | Misc. Professional Services | Part B MAC |
| G0333 | Dispensing Fee | DME MAC |
| G0337 - G0365 | Misc. Professional Services | Part B MAC |
| G0372 | Misc. Professional Services | Part B MAC |
| G0378 - G0490 G0491 - G9987 | Misc. Professional Services | Part B MAC |
| J0120 - J1094 | Injection | Part B MAC Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| J1095 | Ophthalmic Drug | Part B MAC |
| J1100 - J2786 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| J2787 | Ophthalmic Drug | Part B MAC |
| J2788 - J3570 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| J3590 - J3591 | Unclassified Biologicals | Part B MAC |
| J7030 - J7131 | Miscellaneous Drugs and Solutions | Part B MAC if incident to a physician's Solutions service or used in an implanted infusion pump. If other, DME MAC. |
| J7170 - J7179 | Clotting Factors | Part B MAC |
| J7180 - J7195 | Antihemophilic Factor | Part B MAC |
| J7196 - J7197 | Antithrombin III | Part B MAC |
| J7198 | Anti-inhibitor; per I.U. | Part B MAC |
| J7199 - J7211 | Other Hemophilia Clotting Factors | Part B MAC |
| J7296 - J7307 | Contraceptives | Part B MAC |
| J7308 - J7309 | Aminolevulinic Acid HCL | Part B MAC |
| J7310 | Ganciclovir, Long-Acting Implant | Part B MAC |
| J7311 - J7316 | Ophthalmic Drugs | Part B MAC |
| J7318 - J7329 | Hyaluronan | Part B MAC |
| J7330 | Autologous Cultured Chondrocytes, Implant | Part B MAC |
| J7336 | Capsaicin | Part B MAC |
| J7340 | Carbidopa/Levodopa | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| J7342 - J7345 | Ciprofloxacin otic & Topical Aminolevulinic Acid | Part B MAC |
| J7500 - J7599 | Immunosuppressive Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| J7604 - J7699 | Inhalation Solutions | Part B MAC if incident to a physician's service. If other, DME MAC. |
| J7799 - J7999 | NOC Drugs, Other than Inhalation Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| J8498 | Anti-emetic Drug | DME MAC |
| J8499 | Prescription Drug, Oral, Non Chemotherapeutic | Part B MAC if incident to a physician's service. If other, DME MAC. |
| J8501 - J8999 | Oral Anti-Cancer Drugs | DME MAC |
| J9000 - J9999 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| K0001 - K0108 | Wheelchairs | DME MAC |
| K0195 | Elevating Leg Rests | DME MAC |
| K0455 | Infusion Pump used for Uninterrupted Administration of Epoprostenal | DME MAC |
| K0462 | Loaner Equipment | DME MAC |
| K0552 - K0605 | External Infusion Pump Supplies & Continuous Glucose Monitor | DME MAC |
| K0606 - K0609 | Defibrillator Accessories | DME MAC |
| K0669 | Wheelchair Cushion | DME MAC |
| K0672 | Soft Interface for Orthosis | DME MAC |
| K0730 | Inhalation Drug Delivery System | DME MAC |
| K0733 | Power Wheelchair Accessory | DME MAC |
| K0738 | Oxygen Equipment | DME MAC |
| K0739 | Repair or Nonroutine Service for DME | Part B MAC if implanted DME. If other, DME MAC |
| K0740 | Repair or Nonroutine Service for Oxygen Equipment | DME MAC |
| K0743 - K0746 | Suction Pump and Dressings | DME MAC |
| K0800 - K0899 | Power Mobility Devices | DME MAC |
| K0900 | Custom DME, other than Wheelchair | DME MAC |
| L0112 - L4631 | Orthotics | DME MAC |
| L5000 - L5999 | Lower Limb Prosthetics | DME MAC |
| L6000 - L7499 | Upper Limb Prosthetics | DME MAC |
| L7510 - L7520 | Repair of Prosthetic Device | Part B MAC if repair of implanted prosthetic device. If other, DME MAC. |
| L7600 - L8485 | Prosthetics | DME MAC |
| L8499 | Unlisted Procedure for Miscellaneous Prosthetic Services | Part B MAC if implanted prosthetic device. If other, DME MAC. |
| L8500 - L8501 | Artificial Larynx; Tracheostomy Speaking Valve | DME MAC |
| L8505 | Artificial Larynx Accessory | DME MAC |
| L8507 | Voice Prosthesis, Patient Inserted | DME MAC |
| L8509 | Voice Prosthesis, Inserted by a Licensed Health Care Provider | Part B MAC for dates of service on or after 10/01/2010. DME MAC for dates of service prior to |
| L8510 | Voice Prosthesis | DME MAC |
| L8511 - L8515 | Voice Prosthesis | Part B MAC if used with tracheoesophageal voice prostheses inserted by a licensed health care provider. If other, DME MAC |
| L8600 - L8699 | Prosthetic Implants | Part B MAC |
| L8701 - L8702 | Assist Device | DME MAC |
| L9900 | Miscellaneous Orthotic or Prosthetic Component or Accessory | Part B MAC if used with implanted prosthetic device. If other, DME MAC. |
| M0075 - M1071 | Medical Services | Part B MAC |
| P2028 - P9615 | Laboratory Tests | Part B MAC |
| Q0035 | Cardio-kymography | Part B MAC |
| Q0081 | Infusion Therapy | Part B MAC |
| Q0083 - Q0085 | Chemotherapy Administration | Part B MAC |
| Q0091 | Smear Preparation | Part B MAC |
| Q0092 | Portable X-ray Setup | Part B MAC |
| Q0111 - Q0115 | Miscellaneous Lab Services | Part B MAC |
| Q0138-Q0139 | Ferumoxytol Injection | Part B MAC |
| Q0144 | Azithromycin Dihydrate | Part B MAC if incident to a physician's service. If other, DME MAC. |
| Q0161 - Q0181 | Anti-emetic | DME MAC |
| Q0477 - Q0509 | Ventricular Assist Devices | Part B MAC |
| Q0510 - Q0514 | Drug Dispensing Fees | DME MAC |
| Q0515 | Sermorelin Acetate | Part B MAC |
| Q1004 - Q1005 | New Technology IOL | Part B MAC |
| Q2004 | Irrigation Solution | Part B MAC |
| Q2009 | Fosphenytoin | Part B MAC |
| Q2017 | Teniposide | Part B MAC |
| Q2026-Q2028 | Injectable Dermal Fillers | Part B MAC |
| Q2034 - Q2039 | Influenza Vaccine | Part B MAC |
| Q2041 - Q2043 | Cellular Immunotherapy | Part B MAC |
| Q2049 - Q2050 | Doxorubicin | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| Q2052 | IVIG Demonstration | DME MAC |
| Q3001 | Supplies for Radiology Procedures | Part B MAC |
| Q3014 | Telehealth Originating Site Facility Fee | Part B MAC |
| Q3027 - Q3028 | Vaccines | Part B MAC |
| Q3031 | Collagen Skin Test | Part B MAC |
| Q4001 - Q4051 | Splints and Casts | Part B MAC |
| Q4074 | Inhalation Drug | Part B MAC if incident to a physician's service. If other, DME MAC. |
| Q4081 | Epoetin | Part B MAC |
| Q4082 | Drug Subject to Competitive Acquisition Program | Part B MAC |
| Q4100 - Q4204 | Skin Substitutes | Part B MAC |
| Q5001 - Q5010 | Hospice Services | Part B MAC |
| Q5101-Q5111 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| Q9950 - Q9954 | Imaging Agents | Part B MAC |
| Q9955 - Q9957 | Microspheres | Part B MAC |
| Q9958 - Q9983 | Imaging Agents & Radiology Supplies | Part B MAC |
| Q9991-Q9992 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
| R0070 - R0076 | Diagnostic Radiology Services | Part B MAC |
| V2020 - V2025 | Frames | DME MAC |
| V2100 - V2513 | Lenses | DME MAC |
| V2520 - V2523 | Hydrophilic Contact Lenses | Part B MAC if incident to a physician's service. If other, DME MAC. |
| V2530 - V2531 | Contact Lenses, Scleral | DME MAC |
| V2599 | Contact Lens, Other Type | Part B MAC if incident to a physician's service. If other, DME MAC. |
| V2600 - V2615 | Low Vision Aids | DME MAC |
| V2623 - V2629 | Prosthetic Eyes | DME MAC |
| V2630 - V2632 | Intraocular Lenses | Part B MAC |
| V2700 - V2780 | Miscellaneous Vision Service | DME MAC |
| V2781 | Progressive Lens | DME MAC |
| V2782 - V2784 | Lenses | DME MAC |
| V2785 | Processing--Corneal Tissue | Part B MAC |
| V2786 | Lens | DME MAC |
| V2787 - V2788 | Intraocular Lenses | Part B MAC |
| V2790 | Amniotic Membrane | Part B MAC |
| V2797 | Vision Supply | DME MAC |
| V2799 | Miscellaneous Vision Service | Part B MAC if supply for an implanted prosthetic device. If other, DME MAC |
| V5008 - V5299 | Hearing Services | Part B MAC |
| V5336 | Repair/Modification of Augmentative Communicative System or Device | DME MAC |
| V5362 - V5364 | Speech Screening | Part B MAC |
Last Updated Dec 09 , 2023
