HCPCS |
DESCRIPTION |
JURISDICTION |
COMMENT |
---|---|---|---|
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 |
Part B MAC if incident to a physician's service. If other, DME MAC. |
|
A4341-A4342 |
Urinary Supplies |
DME MAC |
|
A4344 - A4358 |
Incontinence Supplies/ Urinary Supplies |
Part B MAC if incident to a physician's service. If other, DME MAC. |
|
A4360 - A4437 |
Urinary Supplies |
Part B MAC if incident to a physician's service. If other, 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 |
|
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. |
|
A4457 |
Enema Tube |
Part B MAC if a supply for or inserted by a licensed healthcare provider. 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 - A4468 |
Non-elastic Binder and Garment, Strap, Covering, Exsufflation Belt |
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 |
|
A4540 - A4545 |
Stimulator and Supplies |
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 |
Part B MAC if incident to a physician's service. If other, DME MAC. |
|
A5102 - A5200 |
Additional Incontinence and Ostomy Supplies |
Part B MAC if incident to a physician's service. If other, 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. |
|
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 |
|
A6520 - A6549 |
Gradient Compression Garments |
DME MAC |
|
A6550 |
Supplies for Negative Pressure Wound Therapy Electrical Pump |
DME MAC |
|
A6552- A6589; A6593- A6610 |
Lymphedema Compression Items |
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 |
|
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 |
|
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 |
|
E0530 |
Electric Sleep Apnea Treatment |
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 |
|
E0650 - E0683 |
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 - E0716 |
Restraints/Enclosures; Pelvic Device |
DME MAC |
|
E0720 - E0745 |
Electrical Nerve Stimulators; Rehab System |
DME MAC |
|
E0747 - E0748 |
Osteogenic Stimulators |
DME 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 |
|
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 |
Artifical 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 |
|
E2000 - E2001 |
Suction Pump |
DME MAC |
|
E2100 - E2104 |
Blood Glucose Monitors with special Features: Continuous Glucose Monitor |
DME MAC |
|
E2120 |
Pulse Generator for Tympanic Treatment of Inner Ear |
DME MAC |
|
E2201 - E2299 |
Wheelchair Accessories |
DME MAC |
|
E2301 - 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 |
|
E3000 - E3200 |
Devices |
DME MAC |
|
E8000 - E8002 |
Gait Trainers |
DME MAC |
|
G0333 |
Dispensing Fee |
DME MAC |
|
J0120-J0134 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0136-J0567 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J0135 has been terminated as of 12/31/24 |
J0571-J0575 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J0570 has been terminated as of 12/31/24 |
J0577-J0600 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0606 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0610-J0614 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0616-J0749 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0750 - J0751 |
Oral |
Part B MAC or DME MAC |
|
J0752 - J0798 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0799 |
NOC Drugs |
Part B MAC or DME MAC |
|
J0800 - J0900 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J0902 - -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. |
|
J1105 |
Oral |
Part B MAC if incident to a physician's service If other, DME MAC. |
|
J1106 - J1169 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J1171 - 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 - J2000 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J2002 -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. |
|
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-J2795 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J2797-J2805 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J2796 has been terminated as of 12/31/24 |
J2807-J2919 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
J2806 has been terminated as of 12/31/24 |
J2921 -J2929 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J2931-J3356 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J3359-J3400 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
J3401 |
Topical |
Part B MAC if incident to a physician's service 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. |
|
J7601 |
Inhalation Suspension |
Part B MAC if incident to a physician's service. 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 |
Part B MAC if incident to a physician's |
|
Inhalation Drugs |
service or used in an implanted infusion pump. If other, DME MAC. |
||
J8498 |
Anti-emetic Drug |
DME MAC |
|
J8499 |
Prescription Drug, Oral, Non |
Part B MAC if incident to a physician's |
|
Chemotherapeutic |
service. If other, DME MAC. |
||
J8501 - J8519 |
Oral Anti-Cancer Drugs |
DME MAC |
|
J8522 - J8999 |
Oral Anti-Cancer Drugs |
DME MAC |
|
J9000 - J9057 |
Chemotherapy Drugs |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC |
J9058 and J9059 has been terminated as of 12/31/24 |
J9060 - J9065 |
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-J9257 |
Chemotherapy Drugs |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC |
|
J9260 - J9370 |
Chemotherapy Drugs |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC |
J9259 has been terminated as of 12/31/24 |
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 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 |
|
L8701-L8721 |
Devices |
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. |
|
Q0155 |
Anti-emetic |
DME MAC |
|
Q0161 - Q0181 |
Anti-emetic |
DME MAC |
|
Q0510 - Q0514 |
Drug Dispensing Fees |
DME MAC |
|
Q0521 |
Supply fee HIV prep |
Part B MAC if incident to a physician's Service, If other, DME MAC |
Q0516-Q0520 has been terminated 12/31/24 and Q0521 has been added as of 1/1/25 |
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 |
DME MAC |
|
Q4074 |
Inhalation Drug |
Part B MAC if incident to a physician's service. If other, DME MAC. |
|
Q5101-Q5130 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
Q5131 and Q5132 has been terminated as of 12/31/24 |
Q5133-Q5136 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. |
|
Q5139-Q5146 |
Injection |
Part B MAC if incident to a physician's service or used in an implanted infusion pump. 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 |