Written and maintained by CASRAI Editorial Board
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General billing-code information for readers who work with durable medical equipment (DME) claims. It is not medical, legal or coverage advice for any individual claim.
Short answer
DME modifiers are two-character codes added to a HCPCS item code on a Medicare DME claim. The Medicare DME MAC Jurisdiction D page groups them by the question each one answers: NU, UE and RR say whether an item was bought new, bought used or rented; KH, KI and KJ say which month of a rental the line represents; KX says the requirements in the medical policy have been met.
Definition and scope
A modifier changes or adds information to a HCPCS code without changing what the code describes. This page covers the DME and DMEPOS modifiers listed on the Noridian JD DME MAC modifiers page (checked 2026-11-01). It applies to Medicare claims. Other payers, including Medicaid and commercial plans, set their own modifier rules, and a summary written for Medicare should not be assumed to apply to them. For modifiers across all HCPCS categories, see HCPCS code modifiers; for the code set itself, see HCPCS Level II codes.
How the modifiers are used in practice
Position order on the claim
Noridian describes a position order. The first position holds the pricing modifiers (RR, KH, KI, KJ and NU). The second holds policy-requirement modifiers such as KX. Any further positions hold other informational modifiers. The claim form accepts up to four modifiers; if more are needed, modifier 99 goes in the fourth position and the remaining modifiers are described in the narrative. For bilateral items, Noridian says to bill two claim lines, one with RT and one with LT, at one unit each.
NU, UE and RR: purchase or rental
Noridian lists NU as a “new durable medical equipment purchase” and UE as a “used durable medical equipment purchase”. RR is the rental modifier, to be used when the DME is rented. These three answer one question: how did the item change hands?
KH, KI and KJ: which rental month
Noridian describes KH as a DMEPOS item, initial claim, purchase or first month rental. KI is a DMEPOS item, second or third month rental. KJ is a DMEPOS item, parenteral enteral nutrition (PEN) pump or capped rental, months four to fifteen. Because the month range is published by the DME MAC, read it from the current MAC page rather than from a third-party list.
KX: requirements in the medical policy met
KX means that the requirements specified in the medical policy have been met. Which requirements those are depends on the item and its policy; this page does not list them. For the general meaning of KX, see HCPCS modifier KX: requirements met.
Types at a glance
| Modifier | Question it answers | Noridian description |
|---|---|---|
| NU | Bought new? | New durable medical equipment purchase |
| UE | Bought used? | Used durable medical equipment purchase |
| RR | Rented? | Rental; use when the DME is to be rented |
| KH | First rental month or purchase? | DMEPOS item, initial claim, purchase or first month rental |
| KI | Second or third rental month? | DMEPOS item, second or third month rental |
| KJ | Later capped-rental or PEN pump month? | DMEPOS item, parenteral enteral nutrition (PEN) pump or capped rental, months four to fifteen |
| KX | Policy requirements met? | Requirements specified in the medical policy have been met |
Source for every row: Noridian JD DME, Modifiers page, checked 2026-11-01.
Where it matters for labs, clinics and supply decisions
A dated change: KH on purchased capped rental items
CMS Transmittal 4052 (Pub. 100-04, Medicare Claims Processing, Change Request 10422, dated May 17, 2018) is titled “Removal of KH Modifier from Capped Rental Claims”. It removed the requirement to append KH on purchased capped rental DME and parenteral/enteral items, for dates of service on or after October 1, 2018. The change touches Chapter 20, section 130.9, “Showing Whether Rented or Purchased”. Older code lists and training material may still show KH as required for those purchases, so check the date of any list you rely on.
Why lists disagree
- The KJ range is stated differently by different publishers. Noridian says months four to fifteen and includes PEN pumps. A supplier-side summary, the Ossur DMEPOS modifiers page dated 10-15-2025, says months four through thirteen and says its rules are Medicare-only. When sources differ, the DME MAC page is the one that administers the claims.
- Noridian’s Modifier Lookup Tool is described as assisting in determining “potential” modifiers for DMEPOS HCPCS codes. A lookup result is a starting point, not a confirmation that a modifier applies to a particular claim.
- A list of modifier descriptions does not say which modifier an individual HCPCS code requires; that is set by the code’s own policy.
Related CASRAI pages: hospital bed Medicare requirements for one DME item category, and DMEPOS supplier standards.
Common misunderstandings
- “NU and RR are the same kind of modifier as KX.” Noridian places NU and RR among the first-position pricing modifiers, and KX in the second position as a policy modifier.
- “Every DME claim line carries all of these.” Each modifier answers a different question (purchase or rental, rental month, policy met), and the claim form holds at most four.
- “KH is always required.” Not for purchased capped rental or parenteral/enteral items on dates of service from October 1, 2018, per Transmittal 4052.
- “A modifier list is valid for every payer.” The descriptions here come from a Medicare DME MAC; other payers may differ.
FAQ
What is a DME modifier?
A two-character code appended to a HCPCS item code on a DME claim to add information such as new purchase, used purchase, rental or rental month. The descriptions above are from the Noridian JD DME MAC page, checked 2026-11-01.
What does DME modifier NU mean?
NU is a “new durable medical equipment purchase”; UE is its used-equipment counterpart.
What does DME modifier KX mean?
KX means the requirements specified in the medical policy have been met. It goes in the second position, after any pricing modifier.
What is on the DME modifiers list for Medicare?
The core set on the Noridian page is NU, UE, RR, KH, KI, KJ and KX, shown in the table above. Other informational modifiers, such as RT and LT for bilateral items, can appear in later positions.
How many modifiers can a DME claim line have?
The claim form holds up to four. If more are needed, Noridian says to put modifier 99 in the fourth position and give the rest in the narrative.
Sources
- Noridian Healthcare Solutions, JD DME, “Modifiers”: med.noridianmedicare.com/web/jddme/topics/modifiers, checked 2026-11-01.
- CMS, Transmittal 4052, Pub. 100-04, CR 10422, “Removal of KH Modifier from Capped Rental Claims”, May 17, 2018: cms.gov transmittal r4052cp.pdf, checked 2026-11-01.
- Ossur, “DMEPOS Modifiers”, dated 10-15-2025: ossur.com DMEPOS modifiers, checked 2026-11-01, cited only for the differing KJ month range.
