CMS Pub. 100-04, ch. 20, § 130.9

Claims must specify whether equipment is rented or

purchased. For purchased equipment, the itemized bill or

claim must also indicate whether equipment is new or

used. If the provider or supplier fails to indicate on an

assigned claim whether equipment was new or used, the

MAC processing the claims assumes purchased equipment

is used and process the claim accordingly, i.e., they pay on

the basis of the used purchase fee. If an unassigned

purchase claim does not specify whether the item was new

or used, MACs develop the claim with the supplier. The

following table indicates the HCPCS modifiers which are

added to the equipment code to indicate its status: Modifier

Status

-BP The beneficiary has been

informed of the purchase and

rental options and has elected

to purchase the item

-BR The beneficiary has been

informed of the purchase and

rental options and has elected

to rent the item

-BU The beneficiary has been

informed of the purchase and

rental options and after 30

days has not informed the

supplier of his/her decision

-KH DMEPOS item, initial claim,

purchase or first month rental

(no longer required for

purchased (NU modifier

claims) on or after 10/1/18)

-KI DMEPOS item, second or

third month rental

-KJ DMEPOS item, PEN pump or

capped rental months four to

fifteen

-NR New when rented (use the

'NR' modifier when an item

that was new at the time of

rental is subsequently

purchased)

-NU New equipment

-RR Rental (use the 'RR' modifier

when DME is to be rented)

-UE Used durable medical

equipment (no longer requires

the KH modifier for claims

submitted on or after 10/1/18)

HHAs report the appropriate modifier using the ASC X12 837 institutional claim format,

or Form CMS-1450 following the appropriate HCPCS code. A/B MACs (HHH) accept 7

positions in this field for data entry purposes.