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Short answer
DME HCPCS codes are Level II HCPCS codes: one letter followed by four digits, maintained by CMS, that identify durable medical equipment, supplies and related items. In the DME MAC supplier manual the equipment codes appear under letters such as E and K, with orthotic codes under L and supplies under A. A code appearing on a list does not mean Medicare covers the item.
This page is general reference for lab, clinic and supply staff. It is not medical, coding or billing advice for any individual case.
Definition and scope
HCPCS Level II codes "consist of a single alphabetical letter followed by 4 numeric digits," and CMS maintains them, including decisions about additions, revisions and deletions (CMS, Healthcare Common Procedure Coding System page, checked 2026-10-30). CMS explains that Medicare and other insurers cover a variety of services, supplies and equipment that are not identified by CPT codes; Level II covers items such as ambulance services and DMEPOS when used outside a physician’s office. For the difference between the two code sets, see HCPCS vs CPT codes.
DMEPOS stands for durable medical equipment, prosthetics, orthotics and supplies. CMS describes the Part B benefit categories as DME (examples named: hospital beds, wheelchairs, ventilators and oxygen equipment), power mobility devices, prosthetics and orthotics, prosthetic devices such as ostomy bags, surgical dressings, therapeutic shoes for people with diabetes, and lymphedema compression treatment items (CMS, DMEPOS fee schedule page, checked 2026-10-30).
What is DME in healthcare?
DME is medically necessary equipment that Medicare Part B covers under section 1861 of the Social Security Act, grouped by CMS with prosthetics, orthotics and supplies as DMEPOS. Hospital beds, wheelchairs, ventilators and oxygen equipment are CMS’s own examples. For a fuller discussion of what counts, see the durable medical equipment list guide.
How the code families work in practice
The clearest public view of how DME codes are organised is Appendix A, "Level II HCPCS Codes," of the CGS DME MAC Jurisdiction C Supplier Manual (Fall 2026 edition, checked 2026-10-30). For each code it lists the description, a payment category and whether a CMN or DIF applies. The appendix is divided into sections for the letters A, B, E, G, J, K, L, Q and V.
Examples from the appendix (descriptions as printed there) show how the first letter relates to the kind of item:
| Letter section | Example code and appendix description | Payment category in appendix |
|---|---|---|
| A | A4255: Platforms for home blood glucose monitor, 50 per box | 13, Supplies |
| E | E0100: Cane, includes canes of all materials, adjustable or fixed, with tip | 5, Inexpensive and routinely purchased DME |
| E | E0250: Hospital bed, fixed height, with any type side rails, with mattress | 1, Capped rental |
| E | E0431: Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | 6, Oxygen and oxygen equipment |
| K | K0001: Standard wheelchair | 1, Capped rental |
| L | L1900: Ankle foot orthosis (AFO), spring wire, dorsiflexion assist calf band, custom fabricated | 4, Prosthetics and orthotics |
The appendix also contains sections for the letters B, G, J, Q and V.
The payment category column
The appendix assigns every code to one of 22 payment categories. Those named in the manual include 1 Capped Rental, 2 Frequent and Substantial Servicing DME, 3 Customized DMEPOS, 4 Prosthetics and Orthotics, 5 Inexpensive and Routinely Purchased DME, 6 Oxygen and Oxygen Equipment, 11 Ostomy, Trach and Urologicals, 12 Surgical Dressings, 13 Supplies, 14 Not Otherwise Classified, 16 Therapeutic Shoes for Diabetics and 22 Lymphedema Compression Treatment Items. The same letter can therefore sit in different categories: in the examples above, E0100 is category 5, E0250 is category 1 and E0431 is category 6.
Where it matters for labs, clinics and supply decisions
Not otherwise classified codes
Some codes are catch-alls. E1399 is "Durable medical equipment, miscellaneous" and K0108 is "Wheelchair component or accessory, not otherwise specified"; both are payment category 14, Not Otherwise Classified. K0462, "Temporary replacement for patient owned equipment being repaired," is category 5.
Certificates of medical necessity
The appendix states that for dates of service on or after January 1, 2023, CMNs and DIFs are no longer required to be submitted; existing CMNs with an earlier initial date continue for the life of the CMN or DIF. Older supplier forms that mention a CMN column may therefore be out of date.
A checklist for staff handling DME codes
- Confirm the code and its description against the current CMS HCPCS files, since CMS maintains and revises Level II codes.
- Read the payment category in the DME MAC appendix, because it shows whether the item is treated as capped rental, inexpensive or routinely purchased, oxygen, supplies or not otherwise classified.
- Check whether the appendix still lists a CMN or DIF requirement for the code for the date of service.
- Check the payer’s own policy. The appendix notes that "the appearance of a code below does not necessarily indicate that the item is covered by Medicare."
Common misunderstandings
- A listed code is covered. The CGS appendix says otherwise; a code list identifies items, not coverage decisions. See Medicare DME coverage.
- The first letter alone decides the category. The examples show E codes in categories 1, 5 and 6.
- CMNs are always required. Not for dates of service on or after January 1, 2023, per the appendix.
- The DMEPOS fee schedule page lists codes. CMS’s page describes benefit categories and links to fee schedule files; it does not itself list individual HCPCS codes.
Related code guides
Item-level code pages on CASRAI include wheelchair HCPCS codes, Hoyer lift codes, shower chair code E0240 and HCPCS E0601. The administrative side is covered in DME MAC and DMEPOS supplier standards.
FAQ
What is DME in healthcare?
Medically necessary equipment such as hospital beds, wheelchairs, ventilators and oxygen equipment, covered by Medicare Part B within the DMEPOS group (CMS, checked 2026-10-30).
What do DME HCPCS codes look like?
One letter followed by four digits, for example E0100 or K0001.
Who maintains the codes?
CMS maintains HCPCS Level II codes, including additions, revisions and deletions.
Does having a code mean Medicare pays for the item?
No. The DME MAC supplier manual states that a code’s appearance does not necessarily indicate coverage.
Sources
- CMS, Healthcare Common Procedure Coding System (HCPCS), checked 2026-10-30.
- CMS, DMEPOS Fee Schedule, page modified 2026-10-23, checked 2026-10-30.
- CGS Administrators, DME MAC Jurisdiction C Supplier Manual, Appendix A, Level II HCPCS Codes, Fall 2026 edition, checked 2026-10-30.
