DME Billing Services
HCPCS Level II coding, certificates of medical necessity, rental vs purchase, Medicare competitive bidding. DME compliance managed.
Common DME CPT Codes
Our coders handle these dme codes daily. This is not an exhaustive list.
2026 Medicare Allowables for DME CPT Codes by State
Medicare reimbursement for dmeprocedures is not a single national number. Each code's allowable is adjusted by your state's Geographic Practice Cost Index (GPCI) and processed under that state's Medicare Administrative Contractor (MAC), so the same dme CPT code pays a different amount in California than it does in Texas or Florida. The table below shows the 5 core dmecodes our coders bill priced at each state's 2026 locality. The non-facility figure is what an office-based practice collects. The facility figure applies when the service is performed in a hospital-based setting.
Commercial carriers in each state typically reimburse above these Medicare benchmarks and state Medicaid below them, but the Medicare allowable is the contracting anchor every payer negotiation starts from. Compare any individual code across all states with our Medicare fee calculator by state.
| Code | DME Procedure | CA | TX | FL | NY | PA | IL | OH | GA | NC | MI |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 97760 | Orthotic management and training, initial encounter | $51.86 | $45.71 | $46.51 | $50.37 | $45.67 | $45.48 | $43.57 | $44.85 | $44.03 | $44.46 |
| 97761 | Prosthetic training, initial encounter | $45.15 | $40.12 | $40.81 | $44.03 | $40.11 | $39.99 | $38.38 | $39.43 | $38.73 | $39.12 |
| 97763 | Orthotic or prosthetic management, subsequent encounter | $56.71 | $49.64 | $50.53 | $54.88 | $49.58 | $49.32 | $47.17 | $48.64 | $47.72 | $48.18 |
| 95851 | Range of motion measurements per extremity | $29.82 | $25.74 | $26.44 | $28.78 | $25.70 | $25.69 | $24.28 | $25.19 | $24.57 | $24.95 |
| 97140 | Manual therapy techniques | $30.47 | $27.58 | $28.08 | $30.03 | $27.61 | $27.64 | $26.59 | $27.21 | $26.73 | $27.06 |
Full DME fee detail by state
2026 Medicare allowables for dme CPT codes in California, processed under Noridian Healthcare Solutions (Jurisdiction E). See California medical billing.
| Code | Description | Non-Facility | Facility |
|---|---|---|---|
| 97760 | Orthotic management and training, initial encounter | $51.86 | $51.86 |
| 97761 | Prosthetic training, initial encounter | $45.15 | $45.15 |
| 97763 | Orthotic or prosthetic management, subsequent encounter | $56.71 | $56.71 |
| 95851 | Range of motion measurements per extremity | $29.82 | $6.90 |
| 97140 | Manual therapy techniques | $30.47 | $30.47 |
Source: 2026 Medicare Physician Fee Schedule, locality-adjusted by state MAC. Figures are for reference and contracting benchmarks, not a guarantee of payment.
DME Billing Challenges We Solve
Common billing problems in dme and how our team handles them.
CMN Documentation
Incomplete CMN forms are the #1 DME denial reason.
Rental vs Purchase
Capped rental, inexpensive/routine, and frequent service categories each have rules.
Proof of Delivery
Missing delivery documentation = denied claim with no appeal.
Prior Authorization
Many DME items require pre-approval before delivery.
Common DME Denial Reasons
We prevent these before submission and appeal aggressively when they occur.
Revenue Opportunities Most DME Practices Miss
Payer-Specific DME Billing Tips
DME Billing Best Practices
Practical tips from our coding team to maximize reimbursement and minimize denials.
Get Expert DME Billing Support
Free billing assessment for your dme practice. See where revenue is leaking.
Fill in your details and we'll call you back
What We Handle for DME Practices
Why Choose Go Medical Billing for DME
DME is heavily audited. Our processes withstand scrutiny with complete documentation, proper coding, and compliant submission.
We serve dme practices in all 50 states, starting at 2.49% of collections. Our credentialing team handles payer enrollment, and our A/R specialists recover aging claims.
DME Billing by State
We handle dme billing in all 50 states. The 2026 Medicare allowables for dme CPT codes in every state are in the fee table above. Open any state below for its full payer environment, Medicaid rules, and Medicare MAC policies.
Frequently Asked Questions
Get Expert DME Billing Support
Stop losing revenue to dme coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.