New York’s Medicaid DME fee schedule looks simple until a biller reaches the columns after the HCPCS description. A rate may be present, but the same row can also carry a rental amount, a maximum monthly quantity, a By Report indicator, or a numbered authorization code. Those fields are not administrative decoration. They help determine
New York Medicaid DME Fee Schedule 2026: Rates, PA Codes & Billing Guide Read More »
Pennsylvania Medicaid DME billing is not as simple as finding an HCPCS code and copying the reimbursement amount into your billing system. For a Fee-for-Service claim, payment can depend on the exact HCPCS code, provider type, specialty, place of service, applicable modifiers, units, effective date, prior authorization status, and the supplier’s enrollment information. That is
Pennsylvania Medicaid DME Fee Schedule 2026: Rates, Prior Authorization & Billing Guide Read More »
Billing in every medical specialty requires accurate medical coding as it contributes greatly to making prompt reimbursements and compliance with medical payers’ guidelines. So, that is DME Billing. One of the most commonly used HCPCS codes is what most Americans are going through. It is used in sleep therapy as E0601, which is associated with
HCPCS Code E0601: Billing and Documentation Guide Read More »
DMEPOS licensing and registration requirements often depend on the state and the products/services offered. Some states have a very specific and regulated DME license program with routine inspections and extra requirements. Other states have less formalized license programs which may include fewer formalized inspections, but they still have rules governing DME sales based upon the
Which States Require a DME License? Full Guide for DME Suppliers Read More »
Fulfilling DME orders for items that Medicare does not cover may result in loss of dollars in the Medical Supply Industry faster than many other actions. Once an order is shipped and a claim is denied, it is typically impossible to recover payment. Therefore, in order to protect your profit margin, you must be able
Medicare Excluded DME List: A Guide to Items Not Covered by Medicare Part B Read More »
