Durable Medical Equipment (DME) may be furnished to Medicare beneficiaries as new equipment, rental equipment, or used equipment, depending on the HCPCS payment category and payer requirements.

Modifier UE is used to identify that the supplier furnished used durable medical equipment as a purchase. It distinguishes previously owned equipment from brand-new equipment and rental items, ensuring that the payer applies the appropriate reimbursement methodology.

Used DME must still be safe, functional, medically appropriate, and compliant with applicable Medicare and DME supplier standards. Proper documentation and accurate modifier selection are essential to prevent claim denials and payment recoupments.

Modifier

Modifier Name

Used Durable Medical Equipment Purchase

Plain English Explanation

Modifier UE tells the insurance payer:

“The supplier is providing previously owned (used) durable medical equipment that is being purchased rather than rented.”

The equipment has been previously issued or owned but has been properly reconditioned, inspected, and is suitable for reuse when permitted by payer policy.

Purpose of Modifier UE

Modifier UE is used to:

Identify used DME that is being purchased.
Distinguish used equipment from new equipment.
Distinguish purchased equipment from rental equipment.
Support correct Medicare and payer reimbursement.
Comply with DMEPOS billing requirements.

Understanding Modifier UE

Modifier UE identifies equipment that:

Has been previously owned or issued.
Is furnished as a purchase.
Meets applicable safety and quality standards.
Is appropriate for the beneficiary’s medical condition.

Comparison of Common DME Purchase and Rental Modifiers

Modifier	Meaning
UE	Used equipment purchase
NU	New equipment purchase
RR	Rental equipment
RA	Replacement of a DME item
RB	Replacement of a part during repair

When to Use Modifier UE

Use Modifier UE when:

A used DME item is sold to the beneficiary.
The payer recognizes the use of Modifier UE.
The equipment is safe, functional, and medically appropriate.
Documentation supports the purchase.
The HCPCS payment category permits purchase.

Examples may include:

Used manual wheelchairs
Used walkers
Used commode chairs
Used patient lifts
Other qualifying DME items permitted under payer policy

When NOT to Use Modifier UE

Do not use Modifier UE when:

Furnishing brand-new equipment (use NU, when applicable).
Billing rental equipment (use RR).
Billing replacement equipment (use RA, when appropriate).
Billing replacement parts (use RB).
The payer does not permit the purchase of used equipment for the specific HCPCS code.

Medicare Rules

Under Medicare:

Modifier UE identifies used durable medical equipment furnished as a purchase.
The supplier must ensure that the equipment is safe, functional, and meets applicable DME supplier standards.
Coverage depends on:
- Medical necessity.
- Physician order.
- Medicare-covered HCPCS code.
- Applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD).
- DME payment category.

Not all DME items may be furnished as used equipment. Suppliers should verify the applicable DME MAC policy before billing.

Commercial Insurance Rules

Many commercial insurers recognize Modifier UE.

However, payer requirements vary regarding:

Whether used equipment is covered.
Purchase versus rental policies.
Prior authorization.
Replacement intervals.
Documentation requirements.
Reimbursement methodology.

Always verify payer-specific billing policies before claim submission.

Documentation Requirements

Documentation should include:

Physician order or prescription.
Medical necessity documentation.
HCPCS code.
Modifier UE.
Proof of delivery.
Equipment inspection or refurbishment records, when applicable.
Supplier records.
Beneficiary acknowledgment.
Manufacturer, model, and serial number, when available.

Real Billing Examples

Example 1 – Used Manual Wheelchair

A beneficiary purchases a professionally refurbished manual wheelchair that meets all applicable safety requirements.

Billing

HCPCS K0001
Modifier UE

Example 2 – Used Walker

A supplier provides a previously owned walker that has been inspected and approved for reuse.

Billing

HCPCS E0135
Modifier UE

Example 3 – Used Commode Chair

A beneficiary purchases a refurbished bedside commode.

Billing

HCPCS E0163
Modifier UE

Example 4 – Used Patient Lift

A patient purchases a reconditioned patient lift that meets payer requirements.

Billing

Appropriate HCPCS code
Modifier UE

Example 5 – Incorrect Use

A supplier furnishes a brand-new walker but bills:

E0135-UE

This is incorrect because UE identifies used equipment. The correct modifier would generally be NU if the payer requires identification of a new purchase.

CMS-1500 Claim Example

Field	Example
HCPCS	K0001
Modifier	UE
Diagnosis Pointer	Appropriate ICD-10-CM diagnosis
Units	1

Common Denial Reasons

Incorrect modifier.
UE billed for brand-new equipment.
Used equipment not covered by the payer.
Missing physician order.
Missing proof of delivery.
Medical necessity not established.
Incorrect HCPCS code.
Invalid modifier combination.

How to Correct the Denial

Verify whether the equipment is new or used.
Confirm that the payer covers used equipment.
Review the physician order.
Verify proof of delivery.
Ensure the HCPCS code and modifier are correct.
Submit supporting documentation.
Resubmit the corrected claim or file an appeal.

Coding Tips

Use Modifier UE only when the equipment is previously owned.
Verify payer coverage for used equipment before billing.
Maintain refurbishment and inspection records when applicable.
Keep complete proof-of-delivery documentation.
Review DME MAC guidance for payer-specific requirements.

Modifier UE vs Modifier NU

Modifier	Description
UE	Used equipment purchase
NU	New equipment purchase

Modifier UE vs Modifier RR

Modifier	Description
UE	Used equipment purchase
RR	Rental equipment

Modifier UE vs Modifier RA

Modifier	Description
UE	Used equipment purchase
RA	Replacement of DME item

Modifier UE vs Modifier RB

Modifier	Description
UE	Used equipment purchase
RB	Replacement of a part during repair

Frequently Asked Questions (FAQs)

Q1. What does Modifier UE mean?

Answer: It indicates that the supplier furnished used durable medical equipment as a purchase.

Q2. What is the difference between UE and NU?

Answer: UE identifies used equipment, while NU identifies brand-new equipment.

Q3. Can Modifier UE be used for rented equipment?

Answer: No. Rental equipment should generally be billed with Modifier RR.

Q4. Does Medicare always cover used DME?

Answer: No. Coverage depends on the HCPCS code, Medicare payment category, medical necessity, and applicable DME MAC policies.

Q5. Is Modifier UE required on every DME claim?

Answer: No. It is used only when a qualifying used DME item is furnished as a purchase and payer policy recognizes the modifier.

AR Caller Tips

When working DME denials involving Modifier UE:

Verify whether the equipment was new, used, or rented.
Confirm payer coverage for used equipment.
Review physician documentation.
Verify proof of delivery.
Confirm the HCPCS code and modifier.
Obtain refurbishment records if requested.
Document the payer representative’s name, reference number, and appeal instructions.

Interview Questions

Question 1

What does Modifier UE represent?

Answer: Used durable medical equipment furnished as a purchase.

Question 2

What is the difference between Modifier UE and Modifier NU?

Answer: UE is used for previously owned equipment, while NU is used for brand-new equipment.

Question 3

What modifier is used for rental DME?

Answer: Modifier RR.

Question 4

Can Modifier UE be used for every DME item?

Answer: No. Its use depends on the HCPCS payment category and the payer’s coverage policies.

Practice Scenario

Scenario

A supplier furnishes a professionally refurbished manual wheelchair to a Medicare beneficiary. The wheelchair is sold, not rented, and all documentation supporting medical necessity and proof of delivery is complete.

Question

Which modifier should be reported?

Answer

Modifier UE should be appended to the appropriate HCPCS code because the equipment is used and purchased.

Related DME Modifiers

NU – New Durable Medical Equipment Purchase
RR – Rental Durable Medical Equipment
RA – Replacement of DME Item
RB – Replacement of a Part Furnished During Repair
NR – New Equipment Rented and Subsequently Purchased
KH – Initial Claim for First Rental Month
KI – Second or Third Rental Month
KJ – Fourth Through Fifteenth Rental Month

Common Billing Mistakes

Using UE for new equipment.
Billing UE for rental equipment.
Missing proof of delivery.
Missing documentation showing the equipment is used.
Incorrect HCPCS code selection.
Billing used equipment when the payer requires new equipment.
Using incompatible modifier combinations.

Key Takeaways

Modifier UE identifies used durable medical equipment purchased by the beneficiary or payer.
It distinguishes used equipment from new equipment (NU) and rental equipment (RR).
Always verify payer policies before billing used DME.
Maintain complete documentation, including physician orders, proof of delivery, and equipment records.
Proper use of Modifier UE helps ensure accurate reimbursement and reduces claim denials.

References

CMS Medicare Claims Processing Manual, Chapter 20 – DMEPOS.
Medicare Benefit Policy Manual – Durable Medical Equipment.
DME Medicare Administrative Contractor (DME MAC) Supplier Manuals.
HCPCS Level II Code Book.
CMS DMEPOS Supplier Standards.

Conclusion

Modifier UE is an important DME billing modifier used to identify used durable medical equipment furnished as a purchase. Correct application requires confirming that the equipment is previously owned, ensuring it meets quality and safety standards, verifying payer coverage, and maintaining complete supporting documentation. Proper use of Modifier UE promotes Medicare compliance, accurate reimbursement, and fewer DME claim denials.

Educational Disclaimer

This article was prepared with the assistance of artificial intelligence (AI) for educational and informational purposes. It is based on publicly available CMS guidance, Medicare DMEPOS billing principles, and general medical coding practices. It is not an official publication of CMS or the American Medical Association (AMA). Always consult the latest CMS Medicare Claims Processing Manual, HCPCS Level II Code Book, DME Medicare Administrative Contractor (DME MAC) guidance, Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and payer-specific billing policies before coding, billing, or submitting claims.