Billing for Maintenance and Servicing (Providers and Suppliers) (Rev. 1, 10-01-03)

by  Jared Staheli
June 18th, 2015

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 an Servicing

Capped Rental If the service is capped rental, suppliers that bill the DMERC 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 FI 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 DMERCs for maintenance and servicing indicate the HCPCS code of the item serviced and the modifier –RP, replacement or repair.

The HHAs that bill FIs 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 FI for maintenance and servicing of prosthetics and orthotics.

References:

Billing for Maintenance and Servicing (Providers and Suppliers) (Rev. 1, 10-01-03). (2015, June 18). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/billing-for-maintenance-and-servicing-providers-and-suppliers-rev-1-10-01-03-26753.html

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