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2025 HCPCS Modifier code MS

Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty.

Refer to the HCPCS Level II coding manual and Medicare guidelines for proper use of the MS modifier. Always verify the most current guidelines and payer-specific policies before billing.

Medical necessity for the underlying DME must be established.Modifier MS services are medically necessary when the maintenance is required to ensure the continued safe and effective function of the equipment, preventing potential harm to the patient.

The provider's responsibility includes performing general maintenance and servicing of the DME, including inspection and replacement of necessary parts not covered by a warranty.This often includes checking the functionality of the equipment, cleaning and replacing parts, and ensuring the device is safe and effective for patient use.

In simple words: Modifier MS is used when a healthcare provider performs routine maintenance and checks on medical equipment, like oxygen tanks, every six months. It covers the cost of their time and any necessary parts not covered by a warranty.

Modifier MS is used to report a six-month maintenance and servicing fee for durable medical equipment (DME). It covers the costs of reasonable and necessary parts and labor not covered by a manufacturer's or supplier's warranty. This includes general maintenance, servicing, and parts needed to keep the equipment functional. A common example is oxygen equipment maintenance, including labor for performance checks and parts replacement.

Example 1: A patient owns an oxygen concentrator (HCPCS codes E1390-E1392). Six months after the purchase, the provider performs routine maintenance, which includes replacing a filter and checking the device's oxygen output. Modifier MS is appended to the appropriate HCPCS code to bill for the maintenance service., A patient rents a capped rental item prior to January 1, 2006. The provider performs the six-month maintenance check and uses modifier MS to indicate the service provided., A patient has been renting a home compressor for portable gaseous oxygen system (K0738) for 36 months and chooses to continue renting during the 36th month. Six months after the 36 month rental period, the provider can bill for necessary maintenance and service using modifier MS.

Documentation should include the date of service, the type of maintenance performed, a list of parts replaced (if any), the time spent performing the maintenance, and the medical necessity for the DME itself.

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