Showing Whether Rented or Purchased Modifier BP, BR, BU, KH, KI

Claims must specify whether equipment is rented or purchased. For purchased equipment, the itemized bill or claim must also indicate whether equipment is new or used. If the provider or supplier fails to indicate on an assigned claim whether equipment was new or used, the contractor processing the claims assumes purchased equipment is used and process the claim accordingly, i.e., they pay on the basis of the used purchase fee. If an unassigned purchase claim does not specify whether the item was new or used, contractors develop the claim with the supplier. The following table indicates the HCPCS modifiers which are added to the equipment code to indicate its status:


-BP         The beneficiary has been informed of the purchase and rental options and has elected to purchase the item

-BR         The beneficiary has been informed of the purchase and rental options and has elected to rent the item

-BU          The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of                his/her decision

-KH         DMEPOS item, initial claim, purchase or first month rental

-KI            DMEPOS item, second or third month rental

-KJ           DMEPOS item, PEN pump or capped rental months four to fifteen

-NR         New when rented (use the 'NR' modifier when an item that was new at the time of rental is subsequently purchased)

-NU         New equipment

-RR        Rental (use the 'RR' modifier when DME is to be rented)

-UE         Used durable medical equipment


HHAs report the appropriate modifier using the ASC X12 837 institutional claim format, or on Form CMS-1450 following the appropriate HCPCS code. A/B MACs (HHH) accept 7 positions in this field for data entry purposes.