HCPCS codes for durable medical equipment (DME)
Wheelchairs, oxygen, hospital beds, CPAP - durable medical equipment is billed with HCPCS Level II codes (mostly the E and K series) to a separate DME contractor, with its own rules about rental, purchase, and proof of medical necessity. Here is what actually gets these paid.
What the E and K codes cover
Durable medical equipment (DME) is reusable equipment used in the home for a medical reason. Most of it lives in the HCPCS E series, with wheelchairs and power mobility largely in the K series. A few representative codes:
| Code | CMS description |
|---|---|
| E0601 | Continuous positive airway pressure (CPAP) device |
| E1390 | Oxygen concentrator, single delivery port... |
| E0260 | Hospital bed, semi-electric (head and foot adjustment), with any type side rails... |
| E0570 | Nebulizer, with compressor |
| E0143 | Walker, folding, wheeled, adjustable or fixed height |
| K0001 | Standard wheelchair |
| K0813 | Power wheelchair, group 1 standard, portable, sling/solid seat and back... |
Use the lookup tool to confirm the exact descriptor and full text before you bill - many DME codes differ only by a feature (side rails, weight capacity, delivery port) that changes the code.
Rental vs. purchase: RR, NU, UE
DME is supplied either rented or purchased, and the modifier has to match. RR is rental, NU is new purchase, and UE is used equipment. Many high-cost items are capped rental: they bill monthly with RR for up to 13 months, after which ownership transfers, rather than as a one-time purchase. A few categories have their own schedule - oxygen equipment, for example, rents monthly under a separate 36-month cap, not the 13-month capped-rental rule.
E1390-RR-KXWhy: RR shows the concentrator is rented; KX attests the medical-policy requirements (the qualifying test) are met and documented. Drop either modifier and the line is exposed to denial.
The KX modifier and medical necessity
KX means “requirements specified in the medical policy have been met.” On DME it is the supplier's attestation that the coverage criteria in the Local Coverage Determination - a qualifying diagnosis, a test result, a face-to-face encounter, a Standard Written Order - are satisfied and the records exist. It is not a formality: appending KX without the documentation invites a post-payment takeback.
ABN modifiers: GA, GZ, GY
When Medicare may not cover an item, the Advance Beneficiary Notice modifiers tell the payer who is on the hook:
| Modifier | CMS description | Effect |
|---|---|---|
| GA | Waiver of liability statement issued as required by payer policy | ABN on file - patient can be billed if denied |
| GZ | Item or service expected to be denied as not reasonable and necessary | No ABN - will deny, patient not liable |
| GY | Item or service statutorily excluded... | Not a benefit at all - automatic denial |
Common mistakes
- Sending DME to the wrong contractor. DMEPOS goes to the DME MAC, not the Part A/B MAC.
- Mismatched rental/purchase modifier. A purchased item billed with RR (or a capped-rental item billed NU) denies.
- KX without the records. The attestation has to be backed by the LCD documentation.
- Missing order or face-to-face. Many items need a Standard Written Order and, for some, a documented face-to-face encounter.
- GZ when you meant GA. Using GZ (no ABN) forfeits the ability to bill the patient.
Documentation checklist
- Standard Written Order signed by the treating practitioner
- Documented medical necessity and any required qualifying test
- Face-to-face encounter where the item requires one
- Correct rental/purchase modifier (RR / NU / UE)
- KX only when the LCD requirements are met, plus any ABN modifier
Frequently asked questions
Most DME is coded with the HCPCS E series (for example E0601 for a CPAP device or E1390 for an oxygen concentrator). Manual and power wheelchairs are usually in the K series (such as K0001 or K0813), and some supplies sit in the A and L series. This tool covers all of them.
Durable medical equipment is billed to a DME MAC - a Medicare contractor that handles DMEPOS - not to the Part A/B MAC that pays the office visit. Sending a DME line to the wrong contractor is a common, avoidable denial.
They identify how the equipment is supplied: RR for rental, NU for new purchase, and UE for used equipment. Capped-rental items (such as standard wheelchairs and hospital beds) are billed monthly with RR for up to 13 months; oxygen equipment also rents monthly with RR but under its own separate 36-month rental category.
Append KX to attest that the coverage requirements in the applicable medical policy (the LCD) have been met and the supporting documentation is on file - for example a qualifying test result for oxygen. Do not add KX unless the criteria are genuinely met; it is an attestation.
Both signal an expected denial. GA means a signed Advance Beneficiary Notice (ABN) is on file, so the patient can be held responsible. GZ means no ABN was obtained, so the item will deny and the patient cannot be billed. GY marks an item statutorily excluded from the benefit.