Billing for durable medical equipment is not general billing with a different code set. HCPCS coding tied to an order, a face-to-face encounter, and a medical-necessity record that must exist before delivery.
Medicaid rules and supplier requirements vary sharply by state, and no post-hoc documentation rescues a claim.
At a glance
What drives the coding
HCPCS coding tied to an order, a face-to-face encounter, and a medical-necessity record that must exist before delivery.
What drives the payer behavior
Medicaid rules and supplier requirements vary sharply by state, and no post-hoc documentation rescues a claim.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where durable medical equipment claims actually fail
- Documentation assembled after delivery
- Missing face-to-face encounter record
- Item not covered under the state plan
How we work it
We code from what your record documents and query you when it does not support a code, which in durable medical equipment is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your current durable medical equipment denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Durable Medical Equipment Medical Billing by State
Medicare contractor, Medicaid program and managed-care structure, and no-fault rules cadence differ by state. Pick yours for a state-specific guide.
Durable Medical Equipment — Frequently Asked Questions
Do you have coders who know durable medical equipment?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate — hCPCS coding tied to an order, a face-to-face encounter, and a medical-necessity record that must exist before delivery.
Do you guarantee we will collect more?
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No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
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Book a free consultation and we will tell you what your revenue cycle needs and what it costs.
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- Nationwide
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