HCPCS |
Description |
Jurisdiction |
---|---|---|
A4206 - A4209 |
Medical, Surgical, and Self- Administered Injection Supplies |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4210 |
Needle Free Injection Device |
DME MAC |
A4211 |
Medical, Surgical, and Self- Administered Injection Supplies |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4212 |
Non Coring Needle or Stylet with or without Catheter |
Part B MAC |
A4213 - A4215 |
Medical, Surgical, and Self-Administered Injection Supplies |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4216 - A4218 |
Saline |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4220 |
Refill Kit for Implantable Pump |
Part B MAC |
A4221 - A4236 |
Self-Administered Injection and Diabetic Supplies |
DME MAC |
A4244 - A4250 |
Medical, Surgical, and Self-Administered Injection Supplies |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4252 - A4259 |
Diabetic Supplies |
DME MAC |
A4261 |
Cervical Cap for Contraceptive Use |
Part B MAC |
A4262 - A4263 |
Lacrimal Duct Implants |
Part B MAC |
A4264 |
Contraceptive Implant |
Part B MAC |
A4265 |
Paraffin |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4266 - A4269 |
Contraceptives |
Part B MAC |
A4270 |
Endoscope Sheath |
Part B MAC |
A4280 |
Accessory for Breast Prosthesis |
DME MAC |
A4281 - A4286 |
Accessory for Breast Pump |
DME MAC |
A4290 |
Sacral Nerve Stimulation Test Lead |
Part B MAC |
A4300 - A4301 |
Implantable Catheter |
Part B MAC |
A4305 - A4306 |
Disposable Drug Delivery System |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4310 - A4358 |
Incontinence Supplies/Urinary Supplies |
If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
A4360 - A4435 |
Urinary Supplies |
If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
A4450 - A4452 |
Tape; Adhesive Remover |
Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. |
A4453 |
Enema Catheter |
DME MAC *** Effective 10/1/21 |
A4455 – A4456 |
Tape; Adhesive Remover |
Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. |
A4458 - A4459 |
Enema Bag/System |
DME MAC |
A4461 - A4463 |
Surgical Dressing Holders |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4465 - A4467 |
Non-elastic Binder and Garment, Strap, Covering |
DME MAC |
A4470 |
Gravlee Jet Washer |
Part B MAC |
A4480 |
Vabra Aspirator |
Part B MAC |
A4481 |
Tracheostomy Supply |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4483 |
Moisture Exchanger |
DME MAC |
A4490 - A4510 |
Surgical Stockings |
DME MAC |
A4520 |
Diapers |
DME MAC |
A4550 |
Surgical Trays |
Part B MAC |
A4553 - A4554 |
Underpads |
DME MAC |
A4555 - A4558 |
Electrodes; Lead Wires; Conductive Paste |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4559 |
Coupling Gel |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4561 - A4563 |
Pessary; Vaginal Insert |
Part B MAC |
A4565-A4566 |
Sling |
Part B MAC |
A4570 |
Splint |
Part B MAC |
A4575 |
Topical Hyperbaric Oxygen Chamber, Disposable |
DME MAC |
A4580 - A4590 |
Casting Supplies & Material |
Part B MAC |
A4595 |
TENS Supplies |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4600 |
Sleeve for Intermittent Limb Compression Device |
DME MAC |
A4601 - A4602 |
Lithium Replacement Batteries |
DME MAC |
A4604 |
Tubing for Positive Airway Pressure Device |
DME MAC |
A4605 |
Tracheal Suction Catheter |
DME MAC |
A4606 |
Oxygen Probe for Oximeter |
DME MAC |
A4608 |
Transtracheal Oxygen Catheter |
DME MAC |
A4611 - A4613 |
Oxygen Equipment Batteries and Supplies |
DME MAC |
A4614 |
Peak Flow Rate Meter |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4615 - A4629 |
Oxygen & Tracheostomy Supplies |
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. |
A4630 - A4640 |
DME Supplies |
DME MAC |
A4641 - A4642 |
Imaging Agent; Contrast Material |
Part B MAC |
A4648 |
Tissue Marker, Implanted |
Part B MAC |
A4649 |
Miscellaneous Surgical Supplies |
Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A4650 |
Implantable Radiation Dosimeter |
Part B MAC |
A4651 - A4932 |
Supplies for ESRD |
DME MAC (not separately payable) |
A5051 - A5093 |
Additional Ostomy Supplies |
If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
A5102 - A5200 |
Additional Incontinence and Ostomy Supplies |
If provided in the physician's office for a temporary condition, the item is incident to the physician's service & billed to the Part B MAC. If provided in the physician's office or other place of service for a permanent condition, the item is a prosthetic device & billed to the DME MAC. |
A5500 - A5514 |
Therapeutic Shoes |
DME MAC |
A6000 |
Non-Contact Wound Warming Cover |
DME MAC |
A6010-A6024 |
Surgical Dressing |
Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6025 |
Silicone Gel Sheet |
Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6154 - A6411 |
Surgical Dressing |
Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6412 |
Eye Patch |
Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6413 |
Adhesive Bandage |
Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6441 - A6457 |
Surgical Dressings |
Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6460-A6461 |
Surgical Dressing |
Part B MAC |
A6501-A6512 |
Surgical Dressing |
Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. |
A6513 |
Compression Burn Mask |
DME MAC |
A6530 - A6549 |
Compression Gradient Stockings |
DME MAC |
A6550 |
Supplies for Negative Pressure Wound Therapy Electrical Pump |
DME MAC |
A7000 - A7002 |
Accessories for Suction Pumps |
DME MAC |
A7003 - A7039 |
Accessories for Nebulizers, Aspirators and Ventilators |
DME MAC |
A7040 - A7041 |
Chest Drainage Supplies |
Part B MAC |
A7044 - A7047 |
Respiratory Accessories |
DME MAC |
A7048 |
Vacuum Drainage Supply |
Part B MAC |
A7501 - A7527 |
Tracheostomy Supplies |
DME MAC |
A8000 - A8004 |
Protective Helmets |
DME MAC |
A9150 |
Non-Prescription Drugs |
Part B MAC |
A9152 - A9153 |
Vitamins |
Part B MAC |
A9155 |
Artificial Saliva |
Part B MAC |
A9180 |
Lice Infestation Treatment |
Part B MAC |
A9270 |
Noncovered Items or Services |
DME MAC |
A9272 |
Disposable Wound Suction Pump |
DME MAC |
A9273 |
Hot Water Bottles, Ice Caps or Collars, and Heat and/or Cold Wraps |
DME MAC |
A9274 - A9278 |
Glucose Monitoring |
DME MAC |
A9279 |
Monitoring Feature/Device |
DME MAC |
A9280 |
Alarm Device |
DME MAC |
A9281 |
Reaching/Grabbing Device |
DME MAC |
A9282 |
Wig |
DME MAC |
A9283 |
Foot Off Loading Device |
DME MAC |
A9284 - A9286 |
Non-electric Spirometer, Inversion Devices and Hygienic Items |
DME MAC |
A9300 |
Exercise Equipment |
DME MAC |
A9500 - A9700 |
Supplies for Radiology Procedures |
Part B MAC |
A9900 |
Miscellaneous DME Supply or Accessory |
Part B MAC if used with implanted DME. If other, DME MAC. |
A9901 |
Delivery |
DME MAC |
A9999 |
Miscellaneous DME Supply or Accessory |
Part B MAC if used with implanted DME. If other, DME MAC. |
B4034 - B9999 |
Enteral and Parenteral Therapy |
DME MAC |
D0120 - D9999 |
Dental Procedures |
Part B MAC |
E0100 - E0105 |
Canes |
DME MAC |
E0110 - E0118 |
Crutches |
DME MAC |
E0130 - E0159 |
Walkers |
DME MAC |
E0160 - E0175 |
Commodes |
DME MAC |
E0181 - E0199 |
Decubitus Care Equipment |
DME MAC |
E0200 - E0239 |
Heat/Cold Applications |
DME MAC |
E0240 - E0248 |
Bath and Toilet Aids |
DME MAC |
E0249 |
Pad for Heating Unit |
DME MAC |
E0250 - E0304 |
Hospital Beds |
DME MAC |
E0305 - E0326 |
Hospital Bed Accessories |
DME MAC |
E0328 - E0329 |
Pediatric Hospital Beds |
DME MAC |
E0350 - E0352 |
Electronic Bowel Irrigation System |
DME MAC |
E0370 |
Heel Pad |
DME MAC |
E0371 - E0373 |
Decubitus Care Equipment |
DME MAC |
E0424 - E0484 |
Oxygen and Related Respiratory Equipment |
DME MAC |
E0485 - E0486 |
Oral Device to Reduce Airway Collapsibility |
DME MAC |
E0487 |
Electric Spirometer |
DME MAC |
E0500 |
IPPB Machine |
DME MAC |
E0550 - E0585 |
Compressors/Nebulizers |
DME MAC |
E0600 |
Suction Pump |
DME MAC |
E0601 |
CPAP Device |
DME MAC |
E0602 - E0604 |
Breast Pump |
DME MAC |
E0605 |
Vaporizer |
DME MAC |
E0606 |
Drainage Board |
DME MAC |
E0607 |
Home Blood Glucose Monitor |
DME MAC |
E0610 - E0615 |
Pacemaker Monitor |
DME MAC |
E0616 |
Implantable Cardiac Event Recorder |
Part B MAC |
E0617 |
External Defibrillator |
DME MAC |
E0618 - E0619 |
Apnea Monitor |
DME MAC |
E0620 |
Skin Piercing Device |
DME MAC |
E0621 - E0636 |
Patient Lifts |
DME MAC |
E0637 - E0642 |
Standing Devices/Lifts |
DME MAC |
E0650 - E0676 |
Pneumatic Compressor and Appliances |
DME MAC |
E0691 - E0694 |
Ultraviolet Light Therapy Systems |
DME MAC |
E0700 |
Safety Equipment |
DME MAC |
E0705 |
Transfer Board |
DME MAC |
E0710 |
Restraints |
DME MAC |
E0720 - E0745 |
Electrical Nerve Stimulators |
DME MAC |
E0746 |
EMG Device |
Part B MAC |
E0747 - E0748 |
Osteogenic Stimulators |
DME MAC |
E0749 |
Implantable Osteogenic Stimulators |
Part B MAC |
E0755 - E0770 |
Stimulation Devices |
DME MAC |
E0776 |
IV Pole |
DME MAC |
E0779 - E0780 |
External Infusion Pumps |
DME MAC |
E0781 |
Ambulatory Infusion Pump |
DME MAC |
E0782 - E0783 |
Infusion Pumps, Implantable |
Part B MAC |
E0784 |
Infusion Pumps, Insulin |
DME MAC |
E0785 - E0786 |
Implantable Infusion Pump Catheter |
Part B MAC |
E0787 |
Infusion pump, insulin |
DME MAC |
E0791 |
Parenteral Infusion Pump |
DME MAC |
E0830 |
Ambulatory Traction Device |
DME MAC |
E0840 - E0900 |
Traction Equipment |
DME MAC |
E0910 - E0930 |
Trapeze/Fracture Frame |
DME MAC |
E0935 - E0936 |
Passive Motion Exercise Device |
DME MAC |
E0940 |
Trapeze Equipment |
DME MAC |
E0941 |
Traction Equipment |
DME MAC |
E0942 - E0945 |
Orthopedic Devices |
DME MAC |
E0946 - E0948 |
Fracture Frame |
DME MAC |
E0950 - E1298 |
Wheelchairs |
DME MAC |
E1300 - E1310 |
Whirlpool Equipment |
DME MAC |
E1352 - E1392 |
Additional Oxygen Related Equipment |
DME MAC |
E1399 |
Miscellaneous DME |
Part B MAC if implanted DME. If other, DME MAC. |
E1405 - E1406 |
Additional Oxygen Equipment |
DME MAC |
E1500 - E1699 |
Artificial Kidney Machines and Accessories |
DME MAC (not separately payable) |
E1700 - E1702 |
TMJ Device and Supplies |
DME MAC |
E1800 - E1841 |
Dynamic Flexion Devices |
DME MAC |
E1902 |
Communication Board |
DME MAC |
E2000 |
Gastric Suction Pump |
DME MAC |
E2100 - E2101 |
Blood Glucose Monitors with Special Features |
DME MAC |
E2120 |
Pulse Generator for Tympanic Treatment of Inner Ear |
DME MAC |
E2201 - E2398 |
Wheelchair Accessories |
DME MAC |
E2402 |
Negative Pressure Wound Therapy Pump |
DME MAC |
E2500 - E2599 |
Speech Generating Device |
DME MAC |
E2601 - E2633 |
Wheelchair Cushions and Accessories |
DME MAC |
E8000 - E8002 |
Gait Trainers |
DME MAC |
G0008 - G0067 |
Misc. Professional Services |
Part B MAC |
G0068 - G0070 |
Infusion Drug Professional Service |
Part B MAC |
G0071 - G0329 |
Misc. Professional Services |
Part B MAC |
G0333 |
Dispensing Fee |
DME MAC |
G0337 - G0364 |
Misc. Professional Services |
Part B MAC |
G0372 |
Misc. Professional Services |
Part B MAC |
G0378 - G0490 G0491 - G9987 |
Misc. Professional Services |
Part B MAC |
J0120 - J1094 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J1095 - J1097 |
Ophthalmic Drug |
Part B MAC |
J1100 - J2786 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J2787 |
Ophthalmic Drug |
Part B MAC |
J2788 - J3570 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J3590 - J3591 |
Unclassified Biologicals |
Part B MAC |
J7030 - J7131 |
Miscellaneous Drugs and Solutions |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J1769 |
Clotting Factors |
Part B MAC |
J7170 - J7179 |
Clotting Factors |
Part B MAC |
J7180 - J7195 |
Antihemophilic Factor |
Part B MAC |
J7196 - J7197 |
Antithrombin III |
Part B MAC |
J7198 |
Anti-inhibitor; per I.U. |
Part B MAC |
J7199 - J7211 |
Other Hemophilia Clotting Factors |
Part B MAC |
J7212 |
Clotting Factors |
Part B MAC |
J7296 - J7307 |
Contraceptives |
Part B MAC |
J7308 - J7309 |
Aminolevulinic Acid HCL |
Part B MAC |
J7310 |
Ganciclovir, Long-Acting Implant |
Part B MAC |
J7311 - J7316 |
Ophthalmic Drugs |
Part B MAC |
J7318 - J7329 |
Hyaluronan |
Part B MAC |
J7330 |
Autologous Cultured Chondrocytes, Implant |
Part B MAC |
J7331-J7332 |
Hyaluronan |
Part B MAC |
J7333 |
Hyaluronan or derivative |
Part B MAC (Terminate as of 4/1/2021) |
J7336 |
Capsaicin |
Part B MAC |
J7340 |
Carbidopa/Levodopa |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J7342 - J7345 |
Ciprofloxacin otic & Topical Aminolevulinic Acid |
Part B MAC |
J7351-J7352 |
Bimatoprost, intracameral/Afamelanotide implant |
Part B MAC |
J7401 |
Sinus Implant |
Part B MAC (Terminate as of 4/1/2021) |
J7402 |
Sinus |
Part B MAC (Effective 4/1/2021) |
J7500 - J7599 |
Immunosuppressive Drugs |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J7604 - J7699 |
Inhalation Solutions |
Part B MAC if incident to a physician's service. If other, DME MAC. |
J7799 - J7999 |
NOC Drugs, Other than Inhalation Drugs |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J8498 |
Anti-emetic Drug |
DME MAC |
J8499 |
Prescription Drug, Oral, Non-Chemotherapeutic |
Part B MAC if incident to a physician's service. If other, DME MAC. |
J8501 - J8999 |
Oral Anti-Cancer Drugs |
DME MAC |
J9000 - J9999 |
Chemotherapy Drugs |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
K0001 - K0108 |
Wheelchairs |
DME MAC |
K0195 |
Elevating Leg Rests |
DME MAC |
K0455 |
Infusion Pump used for Uninterrupted Administration of Epoprostenal |
DME MAC |
K0462 |
Loaner Equipment |
DME MAC |
K0552 - K0605 |
External Infusion Pump Supplies & Continuous Glucose Monitor |
DME MAC |
K0606 - K0609 |
Defibrillator Accessories |
DME MAC |
K0669 |
Wheelchair Cushion |
DME MAC |
K0672 |
Soft Interface for Orthosis |
DME MAC |
K0730 |
Inhalation Drug Delivery System |
DME MAC |
K0733 |
Power Wheelchair Accessory |
DME MAC |
K0738 |
Oxygen Equipment |
DME MAC |
K0739 |
Repair or Nonroutine Service for DME |
Part B MAC if implanted DME. If other, DME MAC |
K0740 |
Repair or Nonroutine Service for Oxygen Equipment |
DME MAC |
K0743 - K0746 |
Suction Pump and Dressings |
DME MAC |
K0800 - K0899 |
Power Mobility Devices |
DME MAC |
K0900 |
Custom DME, other than Wheelchair |
DME MAC |
K1001-K1004 |
Devices |
DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician). |
K1005 |
Device Accessory |
DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician). |
K1006-K1012 |
Devices |
DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician). (K1010-K1012 will be terminated 4/1/2021) |
K1013-K1020 |
Devices |
DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician). (Effective 4/1/2021) |
K1021 |
Accessory |
DME MAC *** Effective 10/1/2021 |
K1022 – K1027 |
Devices |
DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician) *** Effective 10/1/2021 |
L0112 - L4631 |
Orthotics & Devices |
DME MAC |
L5000 - L5999 |
Lower Limb Prosthetics |
DME MAC |
L6000 - L7499 |
Upper Limb Prosthetics |
DME MAC |
L7510 - L7520 |
Repair of Prosthetic Device |
Part B MAC if repair of implanted prosthetic device. If other, DME MAC. |
L7600 - L8485 |
Prosthetics |
DME MAC |
L8499 |
Unlisted Procedure for Miscellaneous Prosthetic Services |
Part B MAC if implanted prosthetic device. If other, DME MAC. |
L8500 - L8501 |
Artificial Larynx; Tracheostomy Speaking Valve |
DME MAC |
L8505 |
Artificial Larynx Accessory |
DME MAC |
L8507 |
Voice Prosthesis, Patient Inserted |
DME MAC |
L8509 |
Voice Prosthesis, Inserted by a Licensed Health Care Provider |
Part B MAC for dates of service on or after 10/01/2010. DME MAC for dates of service prior to 10/01/2010 |
L8510 |
Voice Prosthesis |
DME MAC |
L8511 - L8515 |
Voice Prosthesis |
Part B MAC if used with tracheoesophageal voice prostheses inserted by a licensed health care provider. If other, DME MAC. |
L8600 - L8699 |
Prosthetic Implants |
Part B MAC |
L8701 - L8702 |
Assist Device |
DME MAC |
L9900 |
Miscellaneous Orthotic or Prosthetic Component or Accessory |
Part B MAC if used with implanted prosthetic device. If other, DME MAC. |
M0075 - M1149 |
Medical Services |
Part B MAC |
P2028 - P9615 |
Laboratory Tests |
Part B MAC |
Q0035 |
Cardio-kymography |
Part B MAC |
Q0081 |
Infusion Therapy |
Part B MAC |
Q0083 - Q0085 |
Chemotherapy Administration |
Part B MAC |
Q0091 |
Smear Preparation |
Part B MAC |
Q0092 |
Portable X-ray Setup |
Part B MAC |
Q0111 - Q0115 |
Miscellaneous Lab Services |
Part B MAC |
Q0138 - Q0139 |
Ferumoxytol Injection |
Part B MAC |
Q0144 |
Azithromycin Dihydrate |
Part B MAC if incident to a physician's service. If other, DME MAC. |
Q0161 - Q0181 |
Anti-emetic |
DME MAC |
Q0239 |
COVID-19 monoclonal antibody administration |
Part B MAC |
Q0243 |
COVID-19 monoclonal antibody administration |
Part B MAC |
Q0245 |
COVID-19 monoclonal antibody administration |
Part B MAC (Effective 2/9/2021) |
Q0477 - Q0509 |
Ventricular Assist Devices |
Part B MAC |
Q0510 - Q0514 |
Drug Dispensing Fees |
DME MAC |
Q0515 |
Sermorelin Acetate |
Part B MAC |
Q1004 - Q1005 |
New Technology IOL |
Part B MAC |
Q2004 |
Irrigation Solution |
Part B MAC |
Q2009 |
Fosphenytoin |
Part B MAC |
Q2017 |
Teniposide |
Part B MAC |
Q2026 - Q2028 |
Injectable Dermal Fillers |
Part B MAC |
Q2034 - Q2039 |
Influenza Vaccine |
Part B MAC |
Q2041 - Q2043 |
Cellular Immunotherapy |
Part B MAC |
Q2049 - Q2050 |
Doxorubicin |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
Q2052 |
IVIG Demonstration |
DME MAC |
Q3001 |
Supplies for Radiology Procedures |
Part B MAC |
Q3014 |
Telehealth Originating Site Facility Fee |
Part B MAC |
Q3027 - Q3028 |
Vaccines |
Part B MAC |
Q3031 |
Collagen Skin Test |
Part B MAC |
Q4001 - Q4051 |
Splints and Casts |
Part B MAC |
Q4074 |
Inhalation Drug |
Part B MAC if incident to a physician's service. If other, DME MAC. |
Q4081 |
Epoetin |
Part B MAC |
Q4082 |
Drug Subject to Competitive Acquisition Program |
Part B MAC |
Q4100 - Q4255 |
Skin Substitutes |
Part B MAC |
Q5001 - Q5010 |
Hospice Services |
Part B MAC |
Q5101 - Q5121 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
Q5122 |
Injection |
Part B MAC |
Q9001-Q9003 |
Assessment/Counseling individual/group VA |
Part B MAC |
Q9950 - Q9954 |
Imaging Agents |
Part B MAC |
Q9955 - Q9957 |
Microspheres |
Part B MAC |
Q9958 - Q9983 |
Imaging Agents & Radiology Supplies |
Part B MAC |
Q9991 - Q9992 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
R0070 - R0076 |
Diagnostic Radiology Services |
Part B MAC |
V2020 - V2025 |
Frames |
DME MAC |
V2100 - V2513 |
Lenses |
DME MAC |
V2520 - V2523 |
Hydrophilic Contact Lenses |
Part B MAC if incident to a physician's service. If other, DME MAC. |
V2524 |
Device |
DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician). |
V2530 - V2531 |
Contact Lenses, Scleral |
DME MAC |
V2599 |
Contact Lens, Other Type |
Part B MAC if incident to a physician's service. If other, DME MAC. |
V2600 - V2615 |
Low Vision Aids |
DME MAC |
V2623 - V2629 |
Prosthetic Eyes |
DME MAC |
V2630 - V2632 |
Intraocular Lenses |
Part B MAC |
V2700 - V2780 |
Miscellaneous Vision Service |
DME MAC |
V2781 |
Progressive Lens |
DME MAC |
V2782 - V2784 |
Lenses |
DME MAC |
V2785 |
Processing--Corneal Tissue |
Part B MAC |
V2786 |
Lens |
DME MAC |
V2787 - V2788 |
Intraocular Lenses |
Part B MAC |
V2790 |
Amniotic Membrane |
Part B MAC |
V2797 |
Vision Supply |
DME MAC |
V2799 |
Miscellaneous Vision Service |
Part B MAC if supply for an implanted prosthetic device. If other, DME MAC. |
V5008 - V5299 |
Hearing Services |
Part B MAC |
V5336 |
Repair/Modification of Augmentative Communicative System or Device |
DME MAC |
V5362 - V5364 |
Speech Screening |
Part B MAC |