RetiredPremera BluecrossPolicy N/A

Modifier NU - New DME Equipment and Modifier NR - New DME Equipment When Rented

Defines when Premera recognizes professional claims submitted with DME modifiers NU (new purchase) and NR (new at time of rental) and who this applies to across Premera and affiliated lines of business.

Policy Summary

PayerPremera Bluecross

PolicyModifier NU - New DME Equipment and Modifier NR - New DME Equipment When Rented

Policy CodePolicy N/A

Change TypeArchival

Effective DateArchived May 7, 2026

Next Review DateN/A

Key ActionAppend modifier NU for new DME purchases and modifier NR when purchasing DME that was new at time of rental; codes submitted without required modifiers will be denied.

SourceLink

POLICY UPDATE CHANGES

Policy archived effective May 7, 2026; refer to Durable Medical Equipment (DME)/Home Medical Equipment (HME) policy for current guidance.

Archivedarchival status

Multiple linesapplies to

5 yrreplacement RUL

Availableexternal code list

Coverage and Reimbursement Criteria

Modifier recognition and reimbursement criteria

Coverage and reimbursement are subject to member eligibility, benefits, and application of Plan coding policies; codes without required modifiers will be denied.

New purchase DME must be billed with modifier NU or NR or claim will be denied

If the DME item is rented, the appropriate rental modifier must be appended: RR for DME rental, KR for rental item billing for a partial month, or LL for lease/rental

Replacement of member-owned DME, orthotic, or prosthetic items at or after the reasonable useful lifetime (RUL = 5 years) must include modifier RA plus either an appropriate rental modifier or a new-purchase modifier

A published list of DME categories and their required modifiers is available externally; presence on that list does not guarantee reimbursement—coverage depends on the member's benefits

Policy Summary

PayerPremera Bluecross

PolicyModifier NU - New DME Equipment and Modifier NR - New DME Equipment When Rented

Policy CodePolicy N/A

Change TypeArchival

Effective DateArchived May 7, 2026

Next Review DateN/A

Key ActionAppend modifier NU for new DME purchases and modifier NR when purchasing DME that was new at time of rental; codes submitted without required modifiers will be denied.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Provider Billing Actions and Denial Risks

Denial Risk

Modifier usage and denial risk

The Plan requires that the following modifiers be appended to a durable medical equipment (DME) service to indicate purchase status: Modifier NU indicates the purchase of new DME; Modifier NR indicates the purchase of DME that was new at the time of rental. Modifier NU is used only for items never previously used by any patient/member. Modifier NR is used only for DME items that were new at the time of rental and are subsequently being purchased. Codes submitted for new DME equipment without modifier NU or NR may be denied reimbursement.

Modifier NU — purchase of new DME (item never previously used)
Modifier NR — purchase of DME that was new at time of rental (subsequent purchase)
Missing NU or NR on purchased-new DME codes may result in denial

Billing Rule

Rental modifiers requirement

When a DME item is being rented, the appropriate rental/lease modifier must be appended to the DME code to indicate rental billing. Use modifier RR for DME rental, KR for rental billing that covers a partial month, or LL for lease rental. For replacement of a member-owned DME, orthotic, or prosthetic item during or after its reasonable useful lifetime (RUL) of 5 years, append modifier RA along with the appropriate DME rental modifier or a new-purchase DME modifier. Refer to the Plan's Payment Policy for details on correctly coding replacements.

RR — DME rental (monthly/daily rental billing)
KR — Rental item billing for a partial month
LL — Lease rental
RA — Replacement of a DME, Orthotic or Prosthetic item; must be used with RR/KR/LL or NU/NR as appropriate
Failure to append required rental/lease modifiers may result in claim denial or incorrect payment

Modifier Definitions

Modifier NU

Modifier NU definitionIndicates the purchase of new DME that has never been previously used by any patient/member.

When to useFor purchases of DME that are brand new and never previously used.

Consequence of omissionCodes submitted for new DME equipment without modifier NU (or NR when appropriate) will be denied reimbursement.

Modifier NR

Modifier NR definitionIndicates the purchase of DME that was new at the time of rental and is subsequently being purchased.

When to useFor purchases of DME that were originally rented as new and later purchased by the member.

Consequence of omissionCodes submitted for new DME equipment without modifier NR (or NU when appropriate) will be denied reimbursement.

Modifier RA (replacement)

Modifier RA definitionIndicates replacement of a member-owned DME, orthotic or prosthetic item being replaced during or after the item's reasonable useful lifetime.

Required pairingMust be appended along with either a DME rental modifier (e.g., RR, KR, LL) or a new purchase DME modifier (NU or NR).

RULUsed when replacement occurs during or after the 5-year RUL.

OpenPayer

Modifier NU - New DME Equipment and Modifier NR - New DME Equipment When Rented

Coverage and Reimbursement Criteria

DME Modifiers and Coding Details

Provider Billing Actions and Denial Risks

Modifier Definitions