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Last Modified: 6/18/2024 Location: FL, PR, USVI Business: Part B

2024 jurisdiction list for DMEPOS HCPCS codes

The following list reflect codes that are either added or discontinued (deleted) each quarter.

July updates are bolded below

Deleted codes are valid for dates of service on or before the date of deletion.
Updated codes are in bold.
All HCPCs code listed have DME or joint MAC Jurisdiction. Any other codes not listed as DME MAC only or dual DME MAC/Part B MAC jurisdiction shall be considered to be A/B MAC (Part B) only jurisdiction.
The jurisdiction list includes codes that are not payable by Medicare. Please consult the Medicare contractor in whose jurisdiction a claim would be filed to determine coverage under Medicare.
For Part B providers within our jurisdiction, please refer to our Fee Schedule code search tool for codes indicated as Part B MAC in the jurisdiction column below.

HCPCS
Description
Jurisdiction
Comments
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.
 
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.
 
A4221 - A4239
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; A4271
Diabetic supplies
DME MAC
 
A4265
Paraffin
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC.
 
A4280
Accessory for breast prosthesis
DME MAC
 
A4281 - A4287
Accessory for breast pump
DME 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 - A4340
Incontinence supplies/urinary supplies
 
A4341 - A4342
Urinary supplies
DME MAC
 
A4344 - A4358
Incontinence supplies/urinary supplies
 
A4360 - A4437
Urinary supplies
 
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
 
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.
 
 
A4453
Enema catheter
DME MAC
 
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.
 
DME 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
 
 
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.
 
A4560
Disposable NMES
DME MAC
 
A4575
Topical hyperbaric oxygen chamber, disposable
DME MAC
 
A4593-A4594
Stimulator and Supplies
DME MAC
 
A4595
TENS supplies
Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC.
 
A4596
Electrical Stimulator Supplies
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
 
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.
 
A4651 - A4932
Supplies for ESRD
DME MAC (not separately payable)
 
A5051 - A5093
Additional ostomy supplies
 
A5102 - A5200
Additional incontinence and ostomy supplies
 
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.
 
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
 
 
A6520 - A6549
Gradient Compression Garments
DME MAC
 
A6550
Supplies for negative pressure wound therapy electrical pump
DME MAC
 
 
A6590 - A7002
Accessories for suction pumps
DME MAC
 
A7003 - A7039
Accessories for nebulizers, aspirators, and ventilators
DME MAC
 
A7044 - A7047
Respiratory accessories
DME MAC
 
A7049
Respiratory Item
DME MAC
 
A7501 - A7527
Tracheostomy supplies
DME MAC
 
A8000 - A8004
Protective helmets
DME MAC
 
A9156; A9268-A9269
Mucoadhesive and Programable oral capsule
DME 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
 
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
 
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
 
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
 
E0490 - E0493
Oral Neuromuscular Stimulator
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
 
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
 
Pneumatic/ Non-Pneumatic Devices and Appliances
DME MAC
 
E0691 - E0694
Ultraviolet light therapy systems
DME MAC
 
E0700
Safety equipment
DME MAC
 
E0705
Transfer board
DME MAC
 
E0710 - E0711
Restraints/Enclosures
DME MAC
 
E0720 - E0745
Electrical nerve stimulators
DME MAC
 
E0747 - E0748
Osteogenic stimulators
DME MAC
 
E0755 - E0770
Stimulation devices
DME MAC
 
E0776
IV pole
DME MAC
 
E0779 - E0780
External infusion pump
DME MAC
 
E0781
Ambulatory infusion pump
DME MAC
 
E0784
Infusion pumps, 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 - E1625
Artificial kidney machines and accessories
DME MAC (not separately payable)
 
E1630 - 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
 
E1905
CBT Device
DME MAC
 
Suction pump
DME MAC
 
E2100 - E2103
Blood glucose monitors with special features: Continuous Glucose Monitor
DME MAC
 
E2120
Pulse generator for tympanic treatment of inner ear
DME MAC
 
E2201 - E2398
Wheelchair accessories
DME MAC
 
E2402
Negative pressure wound and 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
 
G0333
Dispensing fee
DME MAC
 
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
Oral
Part B MAC or DME MAC
 
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
NOC drugs
Part B MAC or DME MAC
 
J0800 - J1019
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J1021 - J1029
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J1031 - J1039
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J1041 - J1094
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC
 
J1100 - J1104
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
 
J1106 - J1839
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J1841 - J1849
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J1851 - J2402
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J2403
Miscellaneous Drug and Solutions
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC
 
J2404-J2779
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
J2780 has been terminated as of 7/1/24
J2781 – J2786
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC
 
J2788 – J2919
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC
 
J2931-J3400
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC
 
 
J3410 - J3570
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME 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
 
J7165
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC
 
J7171
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME 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.
 
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 - J9069
Chemotherapy drugs
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J9071- J9249
Chemotherapy drugs
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
J9251-J9370
Chemotherapy drugs
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
J9371 has been terminated as of 7/1/24
J9372- 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
External infusion pump supplies
DME MAC
 
K0555 - K0605
External Infusion pump supplies
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
 
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).
 
K1007
Devices
DME MAC
 
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).
 
K1035 - K1037
Devices
DME MAC
 
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
 
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.
 
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.
 
Q0144
Azithromycin Dihydrate
Part B MAC if incident to a physician's service. If other, DME MAC.
 
Q0161 - Q0181
Anti-emetic
DME MAC
 
Q0510 - Q0514
Drug dispensing fees
DME 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
 
Q4074
Inhalation drug
Part B MAC if incident to a physician's service. If other, DME MAC.
 
Q5101 - Q5134
Injection
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC.
 
Q5137 - Q5138
Injection
Part B MAC if incident to a physician’s service If other, DME 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.
 
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 - V2526
Hydrophilic Contact Lenses
DME MAC
 
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
 
V2700 - V2780
Miscellaneous vision service
DME MAC
 
V2781
Progressive lens
DME MAC
 
V2782 - V2784
Lenses
DME MAC
 
V2786
Lens
DME MAC
 
V2797
Vision supply
DME MAC
 
V2799
Miscellaneous vision service
Part B MAC if supply for an implanted prosthetic device. If other, DME MAC.
 
V5336
Repair/modification of augmentative communicative system or device
DME MAC
 
References
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.