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Repairs, Maintenance and Replacement

Payment may be made for repair, maintenance, and replacement of medically required DME, including equipment which had been in use before the user enrolled in Part B of the program. In addition, 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 but 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 equipment which a beneficiary owns.

Repairs - Repairs to equipment which a beneficiary owns are covered when necessary to make the equipment 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 - The RA modifier is described as replacement of a DME item, due to loss, irreparable damage, or when the item has been stolen.

Modifier RB - The RB modifier is used for replacement parts furnished in order to repair beneficiary-owned DMEPOS.

Last Updated Jun 22, 2017