CMS Pub. 100-04, ch. 36, § 50.12

Under the DMEPOS Competitive Bidding Program, any DMEPOS supplier, provided they have

a valid Medicare billing number, can furnish and bill for services (labor and parts) associated

with the repair of DME or enteral nutrition equipment owned by beneficiaries who reside in a

CBA. In these situations, Medicare payment for labor will be made based on the standard

payment rules. Medicare payment for claims for replacement parts associated with repairing

competitively bid DME or enteral nutrition equipment, that are submitted with the RB modifier,

will be based on the single payment amount for the part if the part and equipment being repaired

are included in the same competitive bidding product category in the CBA. Otherwise, Medicare

payment for replacement parts associated with repairing equipment owned by the beneficiary

will be made based on the standard payment rules.

The replacement of an entire item, as opposed to the replacement of a part for repair purposes,

which is subject to the DMEPOS Competitive Bidding Program, must be furnished by a contract

supplier. Medicare payment for the replacement item would be based on the single payment

amount for the item in the beneficiary’s CBA. Refer to Pub. 100-04, the Medicare Claims

Processing Manual, Chapter 20, 10.2 for instructions on submitting claims for repairs and

replacements.