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Durable Medical Equipment Bulletin 41: Corrective Mobility System Repair Add-on Payment and Supplemental Payment for Certain Patient Lift Systems

MassHealth·MA · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy·Claims & Billing
Effective date
Jun 1, 2026
We identified it
Jun 18, 2026
Days to comply

Summary

MassHealth established new billing procedures for durable medical equipment repair add-on payments using code K0739 U3 for mobility system repairs completed within 12 days, requiring extensive documentation and quarterly reporting. The policy also creates supplemental payments for patient lift systems (E0639, E0640) for dual eligible members with specific prior authorization requirements.

Action Required

Action needed
Immediately: Update billing system to support K0739 U3 modifier combination for mobility repair add-on payments. Establish workflow to complete repairs within 12 days and document all required timeline information on delivery tickets. Submit baseline reports for any corrective mobility repairs within 6 months of policy date. Begin quarterly performance metric reporting starting first full quarter after baseline submission. For patient lift systems E0639/E0640, obtain MassHealth prior authorization before submitting initial Medicare claims, then adjust crossover claims changing modifier to NU for rental month 1.

Affected Billing Codes

K0739
E0639
E0640