DMECS Basics


The DME Coding System (DMECS) allows you to access an active HCPCS, modifier, current fee schedule, or rural zip code, view the PDAC or SADMERC Product Classification List (PCL) details, or export the quarterly fee schedule. DMECS is available 24 hours a day, seven days a week except when maintenance is being conducted.

Fee Schedules

  • Search for a fee schedule for a certain HCPCS code and/or Date of Service
  • Quarterly fee schedule can be exported to CSV
  • If a code does not have an established Fee Schedule, check DMECS to be sure it is a valid code and call your DME MAC for billing and/or coverage information

HCPCS Information

  • Search by Keyword or HCPCS Code for either Active HCPCS Codes or All HCPCS Codes
  • Level II HCPCS codes billable to DME MAC and beginning with letters A, B, E, G, J, K, L, Q, and V are listed
  • New HCPCS codes are added annually when they are released by CMS and any updates are applied quarterly
  • See Billable vs. Payable HCPCS Codes webpage for more information

Modifiers

  • Search for a modifier description
  • The PDAC can only provide definitions of modifiers as listed on DMECS. If assistance is needed regarding which modifier to use on a claim, contact your DME MAC

PCL

  • Search the PCL for products that have been assigned a code by the PDAC using one or more of the following: Manufacturer/Distributor Name, HCPCS Code, Product Name, Product Model, Classification
  • Coding verification by the PDAC is a voluntary process unless otherwise mandated by DME MAC policy
  • Only products that have been submitted to the PDAC/SADMERC for coding verification are posted to the PCL
  • Product information can be searched by manufacturer/distributor, product name, product/model number or HCPCS code
  • Products listed on the PCL with a comment stating, “Code Reverified” have been submitted for review multiple times. This comment indicates any changes to the product, based on a new coding verification review, have not affected coding assignment
  • If a product is not listed in the PCL, contact PDAC for coding assistance
  • It is the manufacturer responsibility to verify their DMEPOS product information is listed accurately on the PCL and education on assigned code is provided to their distributors and/or suppliers. If any product information is inaccurate on coding verification letter or on the PCL, manufacturer should notify the PDAC immediately
  • Manufacturers/Distributors are responsible to notify the PDAC of any changes involving their products posted on the PCL. View the Product Classification List (PCL) Updates Request webpage for instructions on requesting PCL updates

Rural Zip Code

  • Search for a ZIP Code to determine whether it is a Rural ZIP code

Last Updated: 01/09/2019