HCPCS Modifier RA
Published 07/16/2020
Description
Replacement of a DME, orthotic or prosthetic item.
Guidelines and Instructions
- This modifier is valid for certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) items
- Use this modifier on DMEPOS claims to denote instances where an item is furnished as a replacement for the same item which has been lost, stolen or irreparably damaged
CMS publishes an annual DMEPOS Jurisdiction List on the Durable Medical Equipment (DME) Center page of their website. Items listed as under DME MAC jurisdiction on the DMEPOS Jurisdiction List should be billed to your local DME Medicare Administrative Contractor (MAC). Items listed as under Part B MAC jurisdiction on the DMEPOS Jurisdiction List should be billed to Palmetto GBA Railroad Medicare for Railroad Medicare beneficiaries.
Resources
- CMS Durable Medical Equipment (DME) Center
- Latest DMEPOS Jurisdiction List
- CMS DME MAC Jurisdictions Page
- CMS Review Contractor Directory — Interactive Map