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DME billing services · HCPCS · Rentals · Medicare DMEPOS
PhysiAssist runs billing for durable medical equipment suppliers: orders and documentation checked before delivery, prior authorization, HCPCS coding with the right rental and KX modifiers, claims, denials and AR. Every claim goes out with the records it would need in an audit.
Medicare DME rental modifier finder
Try itModifiers
Payment
Ownership
Medicare DMEPOS rules; commercial plans vary
The basics
DME billing services, or durable medical equipment billing, manage the revenue cycle of a DME supplier: verifying orders and documentation, eligibility and prior authorization, coding items with HCPCS codes and modifiers, billing rentals and purchases, posting payments, working denials and responding to audits. In DME, most denials trace back to documentation, not coding.
Written orders, medical records and proof of delivery checked before billing.
Rental, purchase, KX and ABN modifiers applied to each item's rules.
Rental months tracked, ownership dates and continued need confirmed.
DME MAC jurisdiction rules and plan-specific requirements.
What we check
| Codes | What they cover | What we check |
|---|---|---|
| E0601 · E0562 | CPAP device, heated humidifier | Sleep study, face-to-face, adherence for continued coverage |
| E1390 · E0431 | Oxygen concentrator, portable gaseous oxygen | Qualifying test results, 36-month rental cap |
| E0260 · K0001 | Semi-electric hospital bed, standard wheelchair | Capped rental months and coverage criteria |
| K0800–K0899 | Power mobility devices | Face-to-face exam, prior authorization |
| L1833 · L0650 | Knee and lumbar-sacral orthoses | Prior authorization where required, off-the-shelf vs custom |
| A4253 · A4239 | Glucose test strips, CGM supplies | Quantity limits and refill documentation |
| RR · NU · KH · KI · KJ · KX · GA | Rental, new purchase, rental month, criteria met, ABN on file | Right modifiers in the right order |
Free DME billing audit
Send us a recent month of DME claims. A certified coder checks every one against the documentation and sends a written report you keep, whether or not you work with us.
Claims reviewed
460With an issue
38Dollar impact
$17,900What the report covers
Respiratory, mobility, orthotics, supplies
A CPAP, an oxygen concentrator and a knee brace each follow different coverage, rental and documentation rules. We bill each one the way the DME MAC expects.
The systems we work in every day
We log in to your system; nothing about it changes for your team.
Claims, rejections and remittances worked through your clearinghouse.
Submissions, status checks and renewals in each payer's own portal.
Pricing
One rate of 2.8% to 5% of net collections, quoted in writing before you sign. Where you land depends on monthly collections, specialty mix, the scope of services, and your AR backlog and payer mix.
The rate covers medical coding, claim submission, payment posting, denials and AR follow-up. Front desk services, prior authorization, the reporting dashboard, patient statements, credentialing and digital marketing are quoted separately.
See full pricing and estimate your rate →DME billing services manage the revenue cycle of a durable medical equipment supplier: orders and documentation, eligibility and prior authorization, HCPCS coding with modifiers, rental and purchase claims, payment posting, denials, audits and AR follow-up.
KX tells Medicare that the coverage criteria in the item's local coverage determination are met and documented in the medical record. Billing KX without the documentation on file leads to denials and overpayment findings in audits.
Capped rental items, such as CPAP devices and hospital beds, are billed monthly with RR and KH for month 1, KI for months 2 and 3, and KJ for months 4 through 13. After 13 months of continuous rental, ownership transfers to the patient.
Oxygen equipment is rented monthly for up to 36 months. The supplier keeps the equipment and must continue to furnish it for the rest of its 5-year reasonable useful lifetime.
A valid written order, proof of delivery, medical records that support the item's coverage criteria, and, where required, prior authorization or a certificate of medical necessity, plus continued use and need for rentals.
Yes. We submit prior authorization for items on Medicare's required list, such as certain power mobility devices and orthoses, and for commercial plans that require it.
PhysiAssist charges 2.8% to 5% of net collections for coding, claims, payment posting, denials and AR, quoted in writing before you sign.
We review recent DME claims and send a written report: HCPCS and modifier accuracy, rental month sequencing, KX and documentation support, prior authorization gaps, denials by root cause and the dollar value of each.
A free DME billing audit by a certified coder, with a written report you keep.