Billing Multiple Units of Service with the Same HCPCS Code and Same Date of Service

Suppliers should always bill multiple units of service with the same HCPCS code and the same date of service on one claim line, with these exceptions:

  • Submitted amount exceeds $999,999
  • Single line units exceed 999
  • Modifier requirements i.e., RT, LT for bilateral items, or liability modifiers
  • Nutrition and drugs, different strengths or types of formula with narrative included on claim to explain

If this requirement is not met, the claim will be denied as exact duplicate claim/service and the claim will need to be appealed.



Last Updated Sep 26 , 2023