CurrentPremera BluecrossPolicy CP.PP.380.v2.1

Modifier RR / KR / LL - Durable Medical Equipment (DME) Rental, Partial Month Rental, and Lease/Rental

Defines when Premera recognizes and requires modifiers RR, KR and LL on professional claims for durable medical equipment (DME) rental or lease; applies to Premera and affiliated lines of business and products.

Policy Summary

PayerPremera Bluecross

PolicyModifier RR / KR / LL - Durable Medical Equipment (DME) Rental, Partial Month Rental, and Lease/Rental

Policy CodePolicy CP.PP.380.v2.1

Change TypeClarification and additions (billing and replacement coding)

Effective Date

Next Review Date

Key ActionAppend modifier RR for monthly rental, KR for daily/partial-month rental with from/thru dates (bill separate line for non-contiguous days), and LL for lease applied toward purchase; append RA when replacing member-owned DME after a 5-year RUL.

SourceLink

POLICY UPDATE CHANGES

Added billing instructions for non-continuous daily rental periods (bill separate line for each unique date with unit of one).

Added requirement to append modifier RA when replacing member-owned DME after a 5-year reasonable useful lifetime, along with rental or new purchase modifiers.

Clarified paragraph 3 in the 'Policy' section.

Policy archived effective May 7, 2026 and refers readers to related DME/HME policy.

3required modifiers (RR, KR, LL)

5yreasonable useful lifetime (RUL)

04/06/26last review

05/07/26archive effective

Coverage and Reimbursement Criteria

DME rental/lease coverage requirements

Coverage and reimbursement require proper modifier use and depend on member benefits and plan rules.

Modifier RR, KR or LL must be appended to DME codes to indicate rental or lease status; codes submitted without these modifiers will be denied.

ALL of the following

RR indicates monthly rental.
One full month of rental equals one unit; bill one unit per full month on a single claim line (do not bill 30 units).

ALL of the following

KR indicates daily/partial-month rental.

Policy Summary

PayerPremera Bluecross

PolicyModifier RR / KR / LL - Durable Medical Equipment (DME) Rental, Partial Month Rental, and Lease/Rental

Policy CodePolicy CP.PP.380.v2.1

Change TypeClarification and additions (billing and replacement coding)

Effective Date

Next Review Date

SourceLink

On This Page

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Required Modifiers and Billing Units

Required modifiers for DME rental/lease and related scenariosModifierCovered

RR	DME rental (monthly)
KR	DME rental item - partial month (daily); requires from/thru dates and units matching days rented
LL	DME lease/rental applied toward final purchase price
NU/NR	NU = New DME; NR = New DME when rented
RA	Replacement of a DME, Orthotic or Prosthetic item

New DME modifiersModifierCovered

NU	New DME
NR	New DME when rented

Replacement modifierModifierCovered

RA	Replacement of a DME, Orthotic or Prosthetic item

Monthly rental units (RR)

DefinitionOne full month of rental equals one unit; bill each full month on a single claim line with one unit (do not bill 30 units).

Billing frequencyEach full month must be billed as one unit per claim line.

Claim consequenceCodes submitted for rented DME without the RR modifier will be denied reimbursement.

Daily rental billing (KR)

DefinitionKR indicates DME rented daily (partial month); submissions must include 'from' and 'through' dates and units matching total days rented.

Non-contiguous daysIf the daily rental period is not continuous, bill a separate line for each unique date of service with a unit of one.

Date requirementsInclude both from and through dates on the claim to support the units billed.

Provider Billing and Documentation Actions

Billing Rule

Append RR/KR/LL modifiers and follow unit/date billing rules

Append the appropriate rental/lease modifier on all DME professional claims: use modifier RR for monthly rental (bill one unit per full month, not 30 units), modifier KR for partial‑month/daily rental (include from/to dates and units matching days rented; if non‑continuous, bill a separate line for each unique date with unit=1), and modifier LL when the rental/lease amount is applied toward final purchase. Codes submitted without RR, KR or LL will be denied reimbursement.

RR = monthly rental; one full month = one unit (bill one unit per month).
KR = partial‑month/daily rental; include 'from' and 'through' dates and units matching total days; non‑continuous days billed as separate lines with unit=1.
LL = lease/rental applied toward final purchase; follow RR/KR unit and date rules.
Codes without RR/KR/LL will be denied.

Documentation Required

Append RA when replacing member‑owned DME after 5‑year RUL

When replacing a member‑owned DME, orthotic or prosthetic item at or after its 5‑year reasonable useful lifetime (RUL), append modifier RA to the procedure code in addition to the appropriate DME rental modifier or a new‑purchase modifier.

RA must be appended along with either a DME rental modifier (RR/KR/LL as applicable) or a new purchase modifier (NU/NR).
Refer to the 'Modifier RA' payment policy for detailed coding guidance.

Modifier and Term Definitions

Modifier RR

ModifierRR - DME rental (monthly).

UseAppend RR to services to indicate monthly rental; follow monthly unit rules (one unit per full month).

DenialCodes submitted for rented DME without RR will be denied reimbursement.

Modifier KR

ModifierKR - DME rental item, partial month (daily).

UseAppend KR for daily/partial-month rentals and include from/thru dates with units equal to days rented.

Non-contiguous billingIf daily rental days are non-contiguous, bill separate lines with unit=1 per date.

Modifier LL

ModifierLL - DME Lease/Rental applied toward final purchase price.

Unit/date rulesDetermination of units and dates of service for LL follows the same criteria as RR and KR.

PurposeIndicates rental amounts are to be applied toward the final purchase price of the DME item.

Reasonable Useful Lifetime (RUL) and replacement coding

DefinitionReasonable Useful Lifetime (RUL) = 5 years for member-owned DME replacement.

Replacement modifierWhen replacing a member-owned DME during or after the 5-year RUL, append modifier RA along with either a DME rental modifier or a new purchase modifier.

ReferenceRefer to the 'Modifier RA - Replacement of a DME, Orthotic or Prosthetic item' Payment Policy for coding details.