DME Billing Services

Specialty Focus

DME Billing That Captures What You've Earned

DME billing is governed by some of the strictest payer rules in healthcare — competitive bidding areas, CMN requirements, face-to-face documentation thresholds, and HCPCS Level II coding precision. A billing error on a complex DME item can result in full recoupment.

Prime Medical Billing's DME specialists handle CMN and LON documentation, competitive bidding compliance, HCPCS Level II coding, and the full prior authorisation workflow for oxygen, wheelchairs, and complex rehabilitation equipment. We also manage repair, replacement, and rental billing with full compliance documentation.

97%

First-Pass Clean Claim Rate

24h

Average Claim Submission

40%

Average A/R Reduction

CMN & Letter of Necessity (LON) management

HCPCS Level II coding accuracy

Prior authorisation processing

Competitive bidding area compliance

Rental vs. purchase billing rules

Repair & replacement billing

Oxygen therapy monthly billing

Audit-ready documentation support

Electronic remittance posting

Monthly performance reporting

Specialty-Trained Coders

Our billers are trained in your specialty's CPT codes, ICD-10 diagnoses, and payer-specific rules — not generalists working across 50 specialties.

97%+ Clean Claim Rate

We scrub and submit clean claims the first time, reducing rework, accelerating payment, and improving your net collection rate.

24-Hour Denial Recovery

Every denied claim is reviewed within 24 hours, root cause identified, corrected, and re-submitted before payer appeal deadlines close.

Full HIPAA Compliance

Encrypted data handling, a signed Business Associate Agreement, and annual compliance audits — your patients' information is always protected.

Maximize Your DME Revenue

Get a free billing audit and find out exactly how much revenue your practice could be recovering. No contracts, no obligation — just results.

Get Your Free Billing Audit Call 346-307-9057

HIPAA Compliant • No Long-Term Contracts • Results in 30 Days

Do you manage Certificate of Medical Necessity (CMN) requirements for DME?

Yes. Many DME categories require a CMN completed by the ordering physician — including oxygen, power wheelchairs, hospital beds, and CPAP/BiPAP equipment. We track which items require CMNs, obtain completed forms from ordering providers, and ensure CMN documentation matches the billed item before submission.

How do you handle HCPCS Level II coding for all DME categories?

HCPCS Level II codes for DME are updated annually and subject to complex coverage policies, local coverage determinations (LCDs), and national coverage determinations (NCDs). Our DME billers maintain current code sets, cross-reference all claims against applicable LCDs, and verify that ICD-10 codes support coverage criteria.

How do you navigate Medicare competitive bidding requirements for DME suppliers?

Suppliers operating in competitive bidding areas must be contract suppliers for bids-winning items. We ensure your supplier number is correctly identified on claims, verify that billed items are covered under your competitive bidding contract where applicable, and manage claims for non-bid items separately.

What is your prior authorization process for high-cost DME?

Power wheelchairs, home ventilators, and other high-cost DME often require prior authorization with extensive supporting documentation. We submit auth requests with face-to-face evaluation notes, functional assessment documentation, and physician justification letters — and we follow up with payers proactively to prevent delays in patient care.

DME Billing That Captures What You've Earned

Key Billing Areas for DME Practices

Built for DME Billing Complexity

Specialty-Trained Coders

97%+ Clean Claim Rate

24-Hour Denial Recovery

Full HIPAA Compliance

Maximize Your DME Revenue

DME Billing — FAQ

We Serve All Medical Specialties