Durable Medical Equipment - Rental/Purchase Grid

Univera Healthcare classifies the HCPCS codes below under its durable medical equipment benefit, based on the Centers for Medicare & Medicaid Services benefit guidelines. Please refer to the Health Plan's Clinical Editing Policy CE-67, Durable Medical Equipment: Rental vs. PurchaseOpen a PDF(login required) for additional information. 

The presence of a HCPCS code on the chart below does not guarantee coverage. Please confirm member eligibility prior to providing durable medical equipment.

Quick Tip: In Adobe Reader, select the Edit tab, choose Find and enter the HCPCS code you're looking for.

DME Rental/Purchase GridOpen a PDF


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