CMS Pub. 100-04, ch. 20, § 130.7

A3-3629

General

Payment is not made for maintenance and servicing if the beneficiary rents the equipment

since payment for maintenance and servicing are included in the rental payments. An

exception to this is the 6-month service fee for capped rental items that the beneficiary

has elected not to purchase (see §40.2 and 130.5).

Where purchase is permitted (including "Capped Rental Items" and where the beneficiary

elects to purchase), payment for reasonable and necessary maintenance and servicing is

made for such purchased equipment.

Coding to Identify Maintenance and Servicing

Capped Rental

If the service is capped rental, suppliers that bill the DME MAC for the maintenance and

servicing fee (see §40.2) use modifier -MS with the HCPCS code for the equipment to

show that parts and labor which are not covered under any manufacturer or supplier

warranty.

The HHAs that bill the A/B MAC (HHH) for maintenance and servicing of capped rental

items use revenue code 0299 along with the appropriate HCPCS code for the equipment.

Not Capped Rental

Suppliers that bill the DME MACs for maintenance and servicing indicate the HCPCS

code of the item serviced and the modifier -RP, replacement or repair.

The HHAs that bill A/B MACs (HHH) for maintenance and servicing use revenue code

0299 and the appropriate HCPCS code for the equipment serviced.

Hospitals report revenue code 0274 along with one of the following HCPCS codes:

L4205, L4210, L7500, L7510, or L7520 when billing the A/B MAC (A) for maintenance

and servicing of prosthetics and orthotics.