CMS Pub. 100-04, ch. 20, § 110

Devices, and Supplies

(Rev. 330, Issued: 10-22-04, Effective: 01-01-05, Implementation: 04-04-05)

Part B suppliers and providers other than Home Health Agencies (HHAs) must bill

DMEPOS to the DME MAC, except claims for implanted DME. Implanted DME and

supplies for the implanted equipment are billed to the A/B MAC (B).

Suppliers and providers must have a supplier billing number issued by the National

Supplier Clearinghouse (NSC) prior to billing the DME MAC.

Institutional providers bill their A/B MAC (A) for prosthetics and orthotics devices and

supplies. Generally, Medicare does not pay for DME in a facility. For hospital

outpatient DME, bills go to the appropriate DME MAC.

DMEPOS provided under a home health plan of care may be billed either by the HHA or

by the supplier (including the HHA with a supplier number if the HHA prefers to bill that

way) to the DME MAC. If the HHA chooses to bill to the A/B MAC (HHH), the HHA

includes the DME on the PPS claim (32x or 33x). If the beneficiary is not under a plan of

care and receives DMEPOS from a HHA, the agency uses bill type 34x.

Beneficiary Submitted Claims must contain an enrolled Medicare Supplier Number.