Speciality billing

Durable Medical Equipment (DME) Billing Services

DMEPOS billing support for equipment orders, medical necessity documentation, HCPCS coding, and payer follow-up.

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Equipment we bill for

Wheelchairs & mobility devices
Hospital beds & support surfaces
Oxygen equipment & concentrators
CPAP / BiPAP & respiratory devices
Orthotics & prosthetics
Walkers, canes & ambulatory aids
Diabetic supplies & monitors
Enteral & infusion equipment

Overview

Durable medical equipment billing requires the applicable order, supporting medical records, accurate HCPCS codes and modifiers, and evidence that coverage requirements are met. AspireMedX supports DME suppliers with documentation review, rental and purchase claims, payment posting, and denial follow-up. Medicare no longer requires Certificates of Medical Necessity (CMNs) or DME Information Forms (DIFs) for dates of service on or after January 1, 2023. This does not remove medical necessity, order, or other applicable documentation requirements; commercial and Medicaid rules must be checked separately.

Medicare documentation reference: CMS guidance on CMN and DIF discontinuation. Requirements vary by payer and date of service.

How AspireMedX handles DME billing

Our billing workflow checks orders, supporting documentation, applicable authorization dates, and rental or purchase requirements before claim submission. We review HCPCS Level II codes and modifiers, track payer responses, and investigate denial reasons. The supplier remains responsible for accurate records, delivery documentation, and meeting applicable coverage requirements. Approval and payment remain subject to payer review.

Why partner with AspireMedX for DME billing

Customized to your setup

Whether you're an independent supplier or a multi-location DME provider, billing is set up around how your intake and fulfillment already work, not a rigid template.

Documentation handled up front

Applicable orders, medical necessity records, proof of delivery, and prior authorizations are checked against the equipment and payer requirements before submission.

Rental & purchase cycles tracked

Monthly rental billing, cap rental rules, and purchase conversions are tracked per item so nothing gets billed past its allowed cycle.

Denials worked, not written off

Every denial is traced to its cause and resubmitted with the missing piece corrected, instead of moving straight to write-off.

Frequently asked questions

Are CMNs and DIFs still required for Medicare DME claims?+

Medicare discontinued CMNs and DIFs for dates of service on or after January 1, 2023. Earlier dates of service may still follow the earlier requirements. Orders, medical necessity records, proof of delivery, and other applicable documentation still matter. Check commercial and Medicaid requirements separately.

What's the difference between DME rental and purchase billing?+

Rental billing recurs monthly against a capped rental period set by the payer, after which some items convert to purchased status; purchase billing is a single claim for the full allowable amount. Which applies depends on the item, the payer, and how long it's expected to be in use - we track that per order so billing switches over at the right point automatically.

Why do DME claims get denied even when the equipment was clearly needed?+

A claim may fail a coverage, documentation, coding, authorization, or delivery requirement even when equipment was prescribed. We review the payer's denial reason against the records to identify whether a corrected claim, additional documentation, or appeal is appropriate. Payment is not guaranteed by medical necessity alone.

Do you handle Medicare and Medicaid DME claims specifically?+

Yes - Medicare and Medicaid DME billing follows its own set of coverage and documentation rules on top of standard HCPCS coding, and we bill both alongside commercial payers.

How long does it take to see a difference after switching?+

Timing depends on claim volume, record completeness, payer processing, and the age of unpaid claims. We review those factors during assessment and agree reporting milestones. Prior denials and appeals can take longer than new submissions, and recovery is not guaranteed.

Ready to simplify your DME billing?

info@aspiremedx.com · +1 (716) 242-2898

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