US · guidance
CMS Pub. 100-04, ch. 10, § 20.2.1
Nonroutine Supply Editing
For home health consolidated billing, nonroutine medical supplies are identified as a list
of discrete items by HCPCS code. Supplies are billed to DME MACs using the
professional claim format, in which line items have both a ‘from’ and ‘to’ date. The line
item ‘from’ date is used to enforce consolidated billing of nonroutine medical supplies.
Claims submitted by providers using the institutional claim format may include a
nonroutine supply HCPCS code in addition to the other services provided. These
supplies are either bundled into the rate paid for the primary service or are otherwise
incident to the primary service(s) being rendered, therefore these supplies do not fall
within the bundling provisions of HH PPS. As a result, supplies reported on institutional
claims are not subject to consolidated billing edits by CWF.
History
(Rev. 2977, Issued; 06-20-14, Effective: 09-23-14; ICD-10: Upon Implementation of ICD-10, Implementation: 09-23-14; ICD-10: Upon Implementation of ICD-10)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
cdfcb9137ec4727098356c2a2ae53e0d02be1dcfa5bd1a8697f286da76afe83f
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