Article Detail - JD DME
Items That Can Be Purchased in Month One
We have received many requests for a list of DME items that can be purchased in month one, for example E0562. These items are included in the Inexpensive and Routinely Purchased (IRP) Items fee schedule category.
An IRP item can be paid as a rental or lump sum purchase. The total payment amount cannot exceed the actual charge or the fee schedule for a purchase.
- Inexpensive DME is defined as equipment where the purchase price does not exceed $150.
- Other Routinely Purchased DME consists of equipment that is purchased at least 75% of the time.
Pricing Modifiers used in this category include:
RR: Rental
NU: Purchase
UE: Purchase of used equipment.
One of these modifiers must be added to any item that falls into the IRP fee schedule category when it is submitted to Medicare. Otherwise, it will be denied, and you will need to resubmit your claim with the appropriate modifier.
Per DMEPOS Supplier Standard Number 5, a supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment. Examples of IRP items include certain canes, walkers, and roll-about chairs.
To find the payment category an item falls within, please visit the PDAC website under DMECS and Fee Schedule Lookup. Enter the HCPCS Code inquiring on and the fee schedule category, the short and long description, the fee schedule (by state), and required modifiers are displayed.