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2025 DMEPOS HCPCS Code Jurisdiction List

  • 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.
J0750 – J0751 Oral Part B MAC or DME MAC
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 or DME MAC
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. 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

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