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Guide Durable Medical Equipment (DME) Manual

The Durable Medical Equipment Manual contains the regulations, administrative and billing instructions, and service codes for durable medical equipment providers. The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. See 101 CMR 322.00.

See the MassHealth DME and Oxygen Payment and Coverage Guidelines Tool for more information about applicable modifiers, place-of-service codes, prior-authorization requirements, service limits, and pricing and markup information.

MassHealth issues transmittal letters to update any part of the provider manual. MassHealth issues provider bulletins to communicate information that is not contained in the provider manual.

Each part of the Durable Medical Equipment Manual is listed below from beginning to end. You can print each part separately (or any individual pages) or print all parts for a complete manual.

Table of Contents

Table of Contents

Table of contents pages i, ii, ii-a, and iii appear at the beginning of Subchapter 1 below

Table of contents page iv appears at the beginning of Subchapter 4 below

Table of contents page v (see below)

Table of contents page vi (see below)

Additional Resources for Table of Contents

Preface

See below for the Durable Medical Equipment (DME) Manual Preface.

Additional Resources for Preface

Subchapters 1 through 3

Administrative and Billing Regulations (apply to all providers).

Additional Resources for Subchapters 1 through 3

Subchapter 4

See below for the Durable Medical Equipment (DME) regulations (130 CMR 409.000).

Additional Resources for Subchapter 4

Subchapter 5

The Administrative and Billing Instructions (Subchapter 5) are divided into seven parts. For instructions for electronic billing, refer to the MassHealth Companion Guides. To request a copy of any of the MassHealth Companion Guides please contact MassHealth Customer Service Center at 1-800-841-2900. For instructions for billing MassHealth using paper claim forms refer to MassHealth Billing Guides for Paper Claim Submitters.

Please see below for Subchapter 5: Administrative and Billing Instructions.

Additional Resources for Subchapter 5

Subchapter 6

See below for service codes for the Durable Medical Equipment (DME) Manual.

Additional Resources for Subchapter 6

MassHealth All Provider Manual Appendices

The MassHealth generic appendices contained in all provider manuals (Appendices A, C, T, U, V, W, X, Y, and Z).

Additional Resources for MassHealth All Provider Manual Appendices

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