Massachusetts Medicaid: Use appropriate billing codes for faster DME claims processing

UnitedHealthcare Community Plan of Massachusetts network health care professionals, please be sure to use the appropriate billing codes and modifier for all durable medical equipment (DME) claims for serviceable, retired backup power wheelchairs.

What you need to do

You’ll need to use the U6 modifier with the following billing repair codes to accurately file DME claims:

Billing repair codes

K0739 RB
K0739 UB

Note: All repairs to a member’s serviceable, retired backup power wheelchair require prior authorization.

How to submit a prior authorization request

You can submit prior authorization requests using the UnitedHealthcare Provider Portal at UHCprovider.com.

• Click Sign In at the top-right corner and enter your One Healthcare ID and password. If you don’t have one, visit UHCprovider.com/access.
• Once signed in, select Prior Authorizations & Notifications, click create a new request and select the appropriate prior authorization type from the dropdown 
• Enter the required information and click continue

To learn more about prior authorizations, view our training guide.

DME claims filing resource from the state

For more information, please see the Massachusetts Executive Office of Health and Human Services Administrative Bulletin 22-14.

PCA-1-24-01732-POE-NN_06112024