2025 DMEPOS HCPCS Code Jurisdiction List – January Update
- Deleted codes are valid for dates of service on or before the date of deletion.
- Updated codes are in bold.
- The jurisdiction list includes codes that are not payable by Medicare. Please consult the Medicare contractor in whose jurisdiction a claim would be filed to determine coverage under Medicare.
- All HCPCs codes listed have DME or joint MAC Jurisdiction. Any other codes not listed as DME MAC only or dual DME MAC/Part B MAC jurisdiction are A/B MAC (Part B) only jurisdiction.
| HCPCS | DESCRIPTION | JURISDICTION | COMMENT |
|---|---|---|---|
| A4206 – A4209 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4210 | Needle Free Injection Device | DME MAC | |
| A4211 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4213 – A4215 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4216 – A4218 | Saline | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4221 – A4239 | Self-Administered Injection and Diabetic Supplies | DME MAC | |
| A4244 – A4250 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4252 – A4259; A4271 | Diabetic Supplies | DME MAC | |
| A4265 | Paraffin | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC | |
| A4280 | Accessory for Breast Prosthesis | DME MAC | |
| A4281 – A4287 | Accessory for Breast Pump | DME MAC | |
| A4305 – A4306 | Disposable Drug Delivery System | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4310 – A4340 | Incontinence Supplies/ Urinary Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A4341 – A4342 | Urinary Supplies | DME MAC | |
| A4344 – A4358 | Incontinence Supplies/ Urinary Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A4360 – A4437 | Urinary Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A4450 – A4452 | Tape; Adhesive Remover | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. | |
| A4453 | Enema Catheter | DME MAC | |
| A4455 – A4456 | Tape; Adhesive Remover | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. | |
| A4457 | Enema Tube | Part B MAC if a supply for or inserted by a licensed healthcare provider. If other, DME MAC | |
| A4458 – A4459 | Enema Bag/System | DME MAC | |
| A4461 – A4463 | Surgical Dressing Holders | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4465 – A4468 | Non-elastic Binder and Garment, Strap, Covering, Exsufflation Belt | DME MAC | |
| A4481 | Tracheostomy Supply | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4483 | Moisture Exchanger | DME MAC | |
| A4490 – A4510 | Surgical Stockings | DME MAC | |
| A4520 | Diapers | DME MAC | |
| A4540 – A4545 | Stimulator and Supplies | DME MAC | |
| A4553 – A4554 | Under pads | DME MAC | |
| A4555 – A4558 | Electrodes; Lead Wires; Conductive Paste | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4559 | Coupling Gel | Part B MAC if incident to a physician's service (Not separately payable). If other, DME MAC. | |
| A4560 | Disposable NMES | DME MAC | |
| A4575 | Topical Hyperbaric Oxygen Chamber, Disposable | DME MAC | |
| A4593 – A4594 | Stimulator and Supplies | DME MAC | |
| A4595 | TENS Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4596 | Electrical Stimulator Supplies | DME MAC | |
| A4600 | Sleeve for Intermittent Limb Compression Device | DME MAC | |
| A4601 – A4602 | Lithium Replacement Batteries | DME MAC | |
| A4604 | Tubing for Positive Airway Pressure Device | DME MAC | |
| A4605 | Tracheal Suction Catheter | DME MAC | |
| A4606 | Oxygen Probe for Oximeter | DME MAC | |
| A4608 | Transtracheal Oxygen Catheter | DME MAC | |
| A4611 – A4613 | Oxygen Equipment Batteries and Supplies | DME MAC | |
| A4614 | Peak Flow Rate Meter | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC | |
| A4615 – A4629 | Oxygen & Tracheostomy Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC | |
| A4630 – A4640 | DME Supplies | DME MAC | |
| A4649 | Miscellaneous Surgical Supplies | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A4651 – A4932 | Supplies for ESRD | DME MAC (not separately payable) | |
| A5051 – A5093 | Additional Ostomy Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A5102 – A5200 | Additional Incontinence and Ostomy Supplies | Part B MAC if incident to a physician's service. If other, DME MAC | |
| A5500 – A5514 | Therapeutic Shoes | DME MAC | |
| A6000 | Non-Contact Wound Warming Cover | DME MAC | |
| A6010 – A6024 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6025 | Silicone Gel Sheet | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6154 – A6411 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6412 | Eye Patch | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6413 | Adhesive Bandage | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6441 – A6457 | Surgical Dressings | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6501 – A6512 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC | |
| A6513 | Compression Burn Mask | DME MAC | |
| A6520 – A6549 | Gradient Compression Garments | DME MAC | |
| A6550 | Supplies for Negative Pressure Wound Therapy Electrical Pump | DME MAC | |
| A6552 – A6589; A6593 – A6610 | Lymphedema Compression Items | DME MAC | |
| A6590 – A7002 | Accessories for Suction Pumps | DME MAC | |
| A7003 – A7039 | Accessories for Nebulizers, Aspirators, & Ventilators | DME MAC | |
| A7044 – A7047 | Respiratory Accessories | DME MAC | |
| A7049 | Respiratory Item | DME MAC | |
| A7501 – A7527 | Tracheostomy Supplies | DME MAC | |
| A8000 – A8004 | Protective Helmets | DME MAC | |
| A9156; A9268 – A9269 | Mucoadhesive and Programable oral capsule | DME MAC | |
| A9270 | Noncovered Items or Services | DME MAC | |
| A9272 | Disposable Wound Suction Pump | DME MAC | |
| A9273 | Hot Water Bottles, Ice Caps or Collars, and Heat and/or Cold Wraps | DME MAC | |
| A9274 – A9278 | Glucose Monitoring | DME MAC | |
| A9279 | Monitoring Feature/Device | DME MAC | |
| A9280 | Alarm Device | DME MAC | |
| A9281 | Reaching/Grabbing Device | DME MAC | |
| A9282 | Wig | DME MAC | |
| A9283 | Foot Off Loading Device | DME MAC | |
| A9284 – A9286 | Non-electric Spirometer, Inversion Devices & Hygienic Items | DME MAC | |
| A9300 | Exercise Equipment | DME MAC | |
| A9900 | Miscellaneous DME Supply or Accessory | Part B MAC if used with implanted DME. If other, DME MAC. | |
| A9901 | Delivery | DME MAC | |
| A9999 | Miscellaneous DME Supply or Accessory | Part B MAC if used with implanted DME. If other, DME MAC. | |
| B4034 – B9999 | Enteral and Parenteral Therapy | DME MAC | |
| E0100 – E0105 | Canes | DME MAC | |
| E0110 – E0118 | Crutches | DME MAC | |
| E0130 – E0159 | Walkers | DME MAC | |
| E0160 – E0175 | Commodes | DME MAC | |
| E0181 – E0199 | Decubitus Care Equipment | DME MAC | |
| E0200 – E0239 | Heat/Cold Applications | DME MAC | |
| E0240 – E0248 | Bath and Toilet Aids | DME MAC | |
| E0249 | Pad for Heating Unit | DME MAC | |
| E0250 – E0304 | Hospital Beds | DME MAC | |
| E0305 – E0326 | Hospital Bed Accessories | DME MAC | |
| E0328 – E0329 | Pediatric Hospital Beds | DME MAC | |
| E0350 – E0352 | Electronic Bowel Irrigation System | DME MAC | |
| E0370 | Heel Pad | DME MAC | |
| E0371 – E0373 | Decubitus Care Equipment | DME MAC | |
| E0424 – E0484 | Oxygen and Related Respiratory Equipment | DME MAC | |
| E0485 – E0486 | Oral Device to Reduce Airway Collapsibility | DME MAC | |
| E0487 | Electric Spirometer | DME MAC | |
| E0490 – E0493 | Oral Neuromuscular Stimulator | DME MAC | |
| E0500 | IPPB Machine | DME MAC | |
| E0530 | Electric Sleep Apnea Treatment | DME MAC | |
| E0550 – E0585 | Compressors/Nebulizers | DME MAC | |
| E0600 | Suction Pump | DME MAC | |
| E0601 | CPAP Device | DME MAC | |
| E0602 – E0604 | Breast Pump | DME MAC | |
| E0605 | Vaporizer | DME MAC | |
| E0606 | Drainage Board | DME MAC | |
| E0607 | Home Blood Glucose Monitor | DME MAC | |
| E0610 – E0615 | Pacemaker Monitor | DME MAC | |
| E0617 | External Defibrillator | DME MAC | |
| E0618 – E0619 | Apnea Monitor | DME MAC | |
| E0620 | Skin Piercing Device | DME MAC | |
| E0621 – E0636 | Patient Lifts | DME MAC | |
| E0637 – E0642 | Standing Devices/Lifts | DME MAC | |
| E0650 – E0683 | Pneumatic/ Non-Pneumatic Devices & Appliances | DME MAC | |
| E0691 – E0694 | Ultraviolet Light Therapy Systems | DME MAC | |
| E0700 | Safety Equipment | DME MAC | |
| E0705 | Transfer Board | DME MAC | |
| E0710 – E0716 | Restraints/Enclosures; Pelvic Device | DME MAC | |
| E0720 – E0745 | Electrical Nerve Stimulators; Rehab System | DME MAC | |
| E0747 – E0748 | Osteogenic Stimulators | DME MAC | |
| E0755 – E0770 | Stimulation Devices | DME MAC | |
| E0776 | IV Pole | DME MAC | |
| E0779 – E0780 | External Infusion Pumps | DME MAC | |
| E0781 | Ambulatory Infusion Pump | DME MAC | |
| E0784 | Infusion Pumps, Insulin | DME MAC | |
| E0791 | Parenteral Infusion Pump | DME MAC | |
| E0830 | Ambulatory Traction Device | DME MAC | |
| E0840 – E0900 | Traction Equipment | DME MAC | |
| E0910 – E0930 | Trapeze/Fracture Frame | DME MAC | |
| E0935 – E0936 | Passive Motion Exercise Device | DME MAC | |
| E0940 | Trapeze Equipment | DME MAC | |
| E0941 | Traction Equipment | DME MAC | |
| E0942 – E0945 | Orthopedic Devices | DME MAC | |
| E0946 – E0948 | Fracture Frame | DME MAC | |
| E0950 – E1298 | Wheelchairs | DME MAC | |
| E1300 – E1310 | Whirlpool Equipment | DME MAC | |
| E1352 – E1392 | Additional Oxygen Related Equipment | DME MAC | |
| E1399 | Miscellaneous DME | Part B MAC if implanted DME. If other, DME MAC. | |
| E1405 – E1406 | Additional Oxygen Equipment | DME MAC | |
| E1500 – E1625 | Artificial Kidney Machines & Accessories | DME MAC (not separately payable) | |
| E1630 – E1699 | Artificial Kidney Machines & Accessories | DME MAC (not separately payable) | |
| E1700 – E1702 | TMJ Device and Supplies | DME MAC | |
| E1800 – E1841 | Dynamic Flexion Devices | DME MAC | |
| E1902 | Communication Board | DME MAC | |
| E1905 | CBT Device | DME MAC | |
| E2000 – E2001 | Suction Pump | DME MAC | |
| E2100 – E2104 | Blood Glucose Monitors with special Features: Continuous Glucose Monitor | DME MAC | |
| E2120 | Pulse Generator for Tympanic Treatment of Inner Ear | DME MAC | |
| E2201 – E2299 | Wheelchair Accessories | DME MAC | |
| E2301 – E2398 | Wheelchair Accessories | DME MAC | |
| E2402 | Negative Pressure Wound Therapy Pump | DME MAC | |
| E2500 – E2599 | Speech Generating Device | DME MAC | |
| E2601 – E2633 | Wheelchair Cushions and Accessories | DME MAC | |
| E3000 – E3200 | Devices | DME MAC | |
| E8000 – E8002 | Gait Trainers | DME MAC | |
| G0333 | Dispensing Fee | DME MAC | |
| J0120 – J0134 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0136 – J0567 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J0135 has been terminated as of 12/31/2024 |
| J0571 – J0575 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J0570 has been terminated as of 12/31/2024 |
| J0577 – J0600 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0606 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0610 – J0614 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0616 – J0749 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J0739 – or Part B Pharmacies (Specialty A5) |
| J0750 – J0751 | Oral | Part B MAC, DME MAC, or Part B Pharmacies (Specialty A5). | |
| J0752 – J0798 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0799 | NOC Drugs | Part B MAC, DME MAC, or Part B Pharmacies (Specialty A5). | |
| J0800 – J0900 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0902 – J1019 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1021 – J1029 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1031 – J1039 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1041 – J1094 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1100 – J1104 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1105 | Oral | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| J1106 – J1169 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1171 – J1839 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1841 – J1849 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1851 – J2000 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2002 – J2402 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2403 | Miscellaneous Drug and Solutions | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2404 – J2779 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2781 – J2786 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2788 – J2795 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2797 – J2805 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J2796 has been terminated as of 12/31/2024 |
| J2807 – J2919 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J2806 has been terminated as of 12/31/2024 |
| J2921 – J2929 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2931–J3356 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J3359 – J3400 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J3401 | Topical | Part B MAC if incident to a physician's service If other, DME MAC. | |
| J3410 – J3570 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7030 – J7131 | Miscellaneous Drugs and Solutions | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7165 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7171 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7340 | Carbidopa/Levodopa | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7500 – J7599 | Immunosuppressive Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7601 | Inhalation Suspension | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| J7604 – J7699 | Inhalation Solutions | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| J7799 – J7999 | NOC Drugs, Other than Inhalation Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J8498 | Anti–emetic Drug | DME MAC | |
| J8499 | Prescription Drug, Oral, Non Chemotherapeutic | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| J8501 – J8519 | Oral Anti-Cancer Drugs | DME MAC | |
| J8522 – J8999 | Oral Anti-Cancer Drugs | DME MAC | |
| J9000 – J9057 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J9058 and J9059 has been terminated as of 12/31/2024 |
| J9060 – J9065 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J9071 – J9249 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J9251 – J9257 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J9260 – J9370 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J9259 has been terminated as of 12/31/2024 |
| J9372 – J9999 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| K0001 – K0108 | Wheelchairs | DME MAC | |
| K0195 | Elevating Leg Rests | DME MAC | |
| K0455 | Infusion Pump used for Uninterrupted Administration of Epoprostenal | DME MAC | |
| K0462 | Loaner Equipment | DME MAC | |
| K0552 | External Infusion Pump Supplies | DME MAC | |
| K0555 – K0605 | External Infusion Pump Supplies | DME MAC | |
| K0606 – K0609 | Defibrillator Accessories | DME MAC | |
| K0669 | Wheelchair Cushion | DME MAC | |
| K0672 | Soft Interface for Orthosis | DME MAC | |
| K0730 | Inhalation Drug Delivery System | DME MAC | |
| K0733 | Power Wheelchair Accessory | DME MAC | |
| K0738 | Oxygen Equipment | DME MAC | |
| K0739 | Repair or Nonroutine Service for DME | Part B MAC if implanted DME. If other, DME MAC. | |
| K0740 | Repair or Nonroutine Service for Oxygen Equipment | DME MAC | |
| K0743 – K0746 | Suction Pump and Dressings | DME MAC | |
| K0800 – K0899 | Power Mobility Devices | DME MAC | |
| K0900 | Custom DME, other than Wheelchair | DME MAC | |
| K1004 | Devices | DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (for example, supplies furnished incident to the professional service of a physician). | |
| K1007 | Devices | DME MAC | |
| K1027 | Devices | DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (for example, supplies furnished incident to the professional service of a physician). | |
| K1035 – K1037 | Devices | DME MAC | |
| L0112 – L4631 | Orthotics & Devices | DME MAC | |
| L5000 – L5999 | Lower Limb Prosthetics | DME MAC | |
| L6000 – L7499 | Upper Limb Prosthetics | DME MAC | |
| L7510 – L7520 | Repair of Prosthetic Device | Part B MAC if repair of implanted prosthetic device. If other, DME MAC. | |
| L7600 – L8485 | Prosthetics | DME MAC | |
| L8499 | Unlisted Procedure for Miscellaneous Prosthetic Services | Part B MAC if implanted prosthetic device. If other, DME MAC. | |
| L8500 – L8501 | Artificial Larynx; Tracheostomy Speaking Valve | DME MAC | |
| L8505 | Artificial Larynx Accessory | DME MAC | |
| L8507 | Voice Prosthesis, Patient Inserted | DME MAC | |
| L8509 | Voice Prosthesis, Inserted by a Licensed Health Care Provider | Part B MAC for dates of service on or after 10/01/2010. DME MAC for dates of service prior to 10/01/2010 | |
| L8510 | Voice Prosthesis | DME MAC | |
| L8511 – L8515 | Voice Prosthesis | Part B MAC if used with tracheoesophageal voice prostheses inserted by a licensed health care provider. If other, DME MAC. | |
| L8701 – L8721 | Devices | DME MAC | |
| L9900 | Miscellaneous Orthotic or Prosthetic Component or Accessory | Part B MAC if used with implanted prosthetic device. If other, DME MAC. | |
| Q0144 | Azithromycin Dihydrate | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| Q0155 | Anti-emetic | DME MAC | |
| Q0161 – Q0181 | Anti-emetic | DME MAC | |
| Q0510 – Q0514 | Drug Dispensing Fees | DME MAC | |
| Q0521 | Supply fee HIV prep | Part B MAC if incident to a physician's Service. If other, DME MAC, or Part B Pharmacies (Specialty A5). | Q0516-Q0520 has been terminated 12/31/2024 and Q0521 has been added as of 01/01/2025 |
| Q2049 – Q2050 | Doxorubicin | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| Q2052 | IVIG | DME MAC | |
| Q4074 | Inhalation Drug | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| Q5101 – Q5130 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | Q5131 and Q5132 has been terminated as of 12/31/2024 |
| Q5133 – Q5136 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| Q5139 – Q5146 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| Q9991 – Q9992 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| V2020 – V2025 | Frames | DME MAC | |
| V2100 – V2513 | Lenses | DME MAC | |
| V2520 – V2523 | Hydrophilic Contact Lenses | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| V2524 – V2526 | Hydrophilic Contact Lenses | DME MAC | |
| V2530 – V2531 | Contact Lenses, Scleral | DME MAC | |
| V2599 | Contact Lens, Other Type | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| V2600 – V2615 | Low Vision Aids | DME MAC | |
| V2623 – V2629 | Prosthetic Eyes | DME MAC | |
| V2700 – V2780 | Miscellaneous Vision Service | DME MAC | |
| V2781 | Progressive Lens | DME MAC | |
| V2782 – V2784 | Lenses | DME MAC | |
| V2786 | Lens | DME MAC | |
| V2797 | Vision Supply | DME MAC | |
| V2799 | Miscellaneous Vision Service | Part B MAC if supply for an implanted prosthetic device. If other, DME MAC. | |
| V5336 | Repair/Modification of Augmentative Communicative System or Device | DME MAC |
Published: 01.06.2025
Revised: 04.25.2025

