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Revyn RCM
DME / DMEPOS Billing

DME & DMEPOS billing that gets equipment paid — not denied

DME billing has its own rules — prior authorizations, strict documentation, and modifier-heavy HCPCS coding — and most billers get it wrong. Revyn specializes in DMEPOS so your equipment claims get approved and paid.

What is DME / DMEPOS billing?

DMEPOS stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. These items are billed with HCPCS Level II codes — not the CPT codes used for office visits — to Medicare's DME MACs, state Medicaid, and commercial payers. Equipment may be purchased, rented, or billed as capped rental, each with its own rules.

Why DME billing trips up most billers

DMEPOS is one of the most documentation-intensive areas of billing. Many items require prior authorization from CMS's Required Prior Authorization List, with standard decisions returned within about seven days. Payment depends on a detailed physician order, a face-to-face encounter, a Written Order Prior to Delivery (WOPD), proof of delivery, and notes that meet the item's Local Coverage Determination (LCD). The wrong modifier (KX, RR, NU, GA) or a missing document means an automatic denial.

How Revyn handles your DME billing

We verify eligibility and secure prior authorizations, review documentation against LCD medical-necessity rules before claims go out, apply accurate HCPCS codes and modifiers, track rentals and proof of delivery, and appeal denials with the supporting records. The result: cleaner DMEPOS claims and fewer write-offs.

DME / DMEPOS Billing — frequently asked questions

Yes — including items on CMS's Required Prior Authorization List. We assemble the documentation (face-to-face notes, WOPD, and medical necessity) so authorizations are approved the first time.

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