Capped rental durable medical equipment (DME) items should be billed with the appropriate capped rental modifier, in accordance with correct coding practices. As we’ve previously announced, any capped rental item that is billed without the proper accompanying capped rental modifier for members of our Tufts Health Together, Tufts Health Plan Senior Care Options, or Tufts Medicare Preferred products may be denied.
When billing capped rental equipment codes for Medicare and MassHealth members, you must use modifier KH for the first month of the rental, modifier KI for the second and third months, and modifier KJ for months four through 13.
We indicated in a previous communication that it is not appropriate to report modifier RR throughout the rental period; however, we would like to clarify that while it is not appropriate to report only the modifier RR throughout the rental period, it is appropriate to report RR in tandem with KH, KI, or KJ, as applicable.
When billing for new and used equipment purchases, providers must continue using the NU (new) and UE (used) modifiers.