Repairs, Maintenance and Replacement - JA DME

• Repairs can be completed by any DMEPOS supplier. The initial supplier is not required to do the repair.
• Payment may be made for repair, maintenance, and replacement of medically required durable medical equipment (DME), orthotics and prosthetics, including items which had been in use before the user enrolled in Medicare Part B.
• Payments for repair and maintenance may not include payment for parts and labor covered under a manufacturer's or supplier's warranty.
• Repair and maintenance of oxygen equipment is not reimbursed separately. This is included in the oxygen rental payment and must be provided by the supplier after oxygen rental payments end for the two years remaining in the equipment's useful lifetime.

Maintenance - More extensive maintenance which, based on the manufacturers' recommendations, is to be performed by authorized technicians, is covered as repairs for medically necessary DME which a beneficiary owns.

Repairs - Repairs to items which a beneficiary owns are covered when necessary to make the item serviceable.

Replacement - Equipment which the beneficiary owns or is a capped rental item may be replaced in cases of loss or irreparable damage. Irreparable damage refers to a specific accident or to a natural disaster, e.g., fire, flood, etc.

Warranties - Any item or labor covered under a manufacturer's warranty cannot be billed to Medicare.

Modifier RA - Replacement of a DME item, due to loss, irreparable damage, or when the item has been stolen.

Modifier RB - Replacement parts furnished in order to repair beneficiary-owned DMEPOS.