December 4, 2025
New Modifier Requirements for Ventilators, Lymphedema Compression Treatment Items, and Pneumatic Compression Devices – Effective January 1, 2026
Starting for dates of service on or after January 1, 2026, suppliers must add one of these modifiers (SC, GA, GY, or GZ) on all claims for:
- Ventilators
- Lymphedema Compression Treatment Items
- Pneumatic Compression Devices and related accessories
The SC modifier (medically necessary service or supply) indicates applicable payment criteria are met based on the relevant National Coverage Determination (NCD) or regulation. Alternatively, the GA, GY, or GZ indicate the applicable payment criteria are not met.
Claim lines billed without a SC, GA, GY or GZ modifier will be rejected for missing information and may be resubmitted with the appropriate modifier.
The DME MACs are implementing these modifiers to reduce Comprehensive Error Rate Testing (CERT) errors, prevent overpayments, and decrease administrative burden to the supplier community.
For more information, see:

