Repair Labor Billing and Payment Policy

Original Effective Date: 02/26/2009
Revision Effective Date: 11/01/2013

Effective for dates of service on or after April 1, 2009, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) are instituting a billing and payment policy for common repairs based on standardized labor times. This applies to non-rented and out-of-warranty items. This effective date coincides with the effective date of the new code for repairs for non-oxygen equipment – K0739 (REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT OTHER THAN OXYGEN REQUIRING THE SKILL OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES). One unit of service = 15 minutes. Code E1340 is no longer valid for repairs for dates of service on or after April 1, 2009.

The following table contains repair units of service allowances for commonly repaired items. Units of service include basic troubleshooting and problem diagnosis. Suppliers are reminded that there is no Medicare payment for travel time or equipment pick-up and/or delivery.

Type of Equipment Part Being Repaired/Replaced Allowed Units of Service (UOS)
Power Wheelchair Batteries (includes cleaning and testing) 2
Power Wheelchair Joystick (includes programming) 2
Power Wheelchair Charger 2
Power Wheelchair Drive wheel motors (single/pair) 2/3
Power Wheelchair Shroud/cowling 2
Power or Manual Wheelchair Wheel/Tire (all types, per wheel) 1
Power or Manual Wheelchair Armrest or armpad 1
Manual Wheelchair Anti-tipping device 1
Hospital Bed Pendant 2
Hospital Bed Headboard/footboard 2
CPAP Blower Assembly 2
Seat Lift Hand Control 2
Seat Lift Scissor Mechanism 3
Patient Lift Hydraulic Pump 2

 

Suppliers may only bill the allowable units of service listed in the above table for each repair, regardless of the actual repair time. Claims for repairs must include narrative information itemizing each repair and the time taken for each repair. Suppliers are also reminded that Medicare does not pay for repairs to capped rental items during the rental period or items under warranty.

            Last Updated Mon, 08 Jan 2018 13:34:08 +0000