- November 4, 2025
- Posted by: Josh Knoll
- Category: DME Billing
DME supply business itself is a complex domain as you juggle patients, physicians, prescriptions, inventory and many other daily chores. Things become even more challenging when suppliers need to manage DME billing for both rentals and purchased devices and each device has its own codes, documentation process, payer rules. A single mistake in a billing process can cause lead to payment denials and delays.
The U.S. durable medical equipment market was valued at $80.9 billion and is projected to reach $137.9 billion by 2033. You must understand how one-time purchases and rentals differ in DME billing services so that you can simplify them to improve cash flow, reduce stress, and make your entire process more efficient.
Now, It’s time to remember the basics of DME rentals and sales:
DME billing purchase Vs Rentals: The key differences
DME items are dispatched and billed in two ways — rentals or sales. Rental billing is used when patients borrow equipment for a limited time and pay monthly until they return it or own it. Items like oxygen concentrators, hospital beds, CPAP or BiPAP machines, and sometimes wheelchairs fall under rentals. You can start the sales billing process when a patient directly purchases equipment outright and pays in one shot. The frequently purchased devices are walkers, nebulizers, glucose monitors, or braces. Now, practices need to know that both the purchased and rented DME billing processes have their respective payer rules and documentation requirements. This makes the job more cumbersome than it seem.
It’s important to understand why these two billing models matter and the complexities involved in each.
Related Reading: How To Streamline DME Billing for A Powerful Collection
Why both billing models matter in DME:
Your billing model shapes how you earn revenue, handle paperwork, manage inventory, and work with insurers. In rental billing, the billing team submits recurring monthly claims and must show continued medical necessity—proof that the patient still uses and needs the equipment as per payer rules. In billing process for purchased items, it’s a one-time claim, but any coding or documentation error can cause total payment loss. Both models need precision, but rental billing adds to the challenges of ongoing compliance and proof of use.
Explore the complexities of rental billing:
Rental billing often feels endless. Here is an example- a supplier has given a patient durable medical equipment on rent, and needs to bill it every month as long as the patient uses it and do the formalities of re-authorization from time to time. You should ensure that the prescription is valid, the patient still needs the equipment and the claim includes the correct HCPCS codes and modifiers like RR. The administrative professionals also have to stay within the payer’s rental period, which for Medicare is usually 13 months. Missing any of these steps can lead to denials. DME suppliers manage hundreds of patients and tracking them manually becomes difficult as each payer has different rules for the DME billing process.
The nuances of handling purchased DME billing:
The purchased DME billing is a one-time process, but it definitely comes with its own pitfalls. The administrative team must know how to properly justify the medical necessity of the equipment and it should only be prescribed by a licensed physician. You should never omit information like physician orders, delivery proof, accurate codes, and all the supporting documents like medical necessity details. You can face claim denials because of a single mistake in your billing process. Your administrative team should carefully check every claim before submission.
The fact is that errors hurt the bottom line of your business and let’s understand how-
How DME billing errors impact your business:
Whether it’s rental or sales billing, even small errors can hurt your revenue. Common mistakes include using the wrong modifiers like RR or NU, missing or expired prescriptions, duplicate billing, missing proof of delivery, or incorrect rental periods. These issues cause claim denials, payment delays, and sometimes audits. Too many denials can also draw payer attention to your DME business for compliance checks. Most of these problems happen because of manual work and poor follow-up mechanism.
Fortunately, you can streamline both your rental and one-time purchased DME billing processes by following the respective strategies mentioned below-
Viable steps to streamline rented DME billing services:
a. Use automated reminders
You should set up reminders for reauthorization, medical necessity renewals, and expiring prescriptions. Don’t wait for payers to flag missing information.
b. Track rental periods accurately
Use billing software like BrightTree, DMEWorks, TeamDME, Care that track rental start and end dates. Medicare, for example, limits certain DME rentals to 13 months. Your system should alert before the end date.
c. Verify patient usage
Regularly confirm that patients are still using the equipment. Maintain documentation such as delivery slips or usage logs.
d. Apply correct modifiers
Your team should double-check if the item should be billed as a rental (RR) or purchase (NU). Modifiers play a huge role in claim acceptance.
e. Keep digital records
Your team can avoid the risk of missing documents by leveraging a smart electronic records storage system. It is crucial to store all the face-to-face notes, prescriptions, and medical necessity forms digitally so that DME suppliers can enjoy immediate access during audits.
The key steps to streamline the purchased DME billing process:
The billing process for purchased DME needs accuracy from the start. Here are some simple steps:
a. Verify coverage before delivery
Your team must check if the item is covered by the patient’s insurance and what the payer’s rules are. Some items require prior authorization.
b. Collect complete documentation upfront
Make sure to provide the payers with doctor’s order, diagnosis, and proof of medical necessity before delivery.
c. Confirm delivery
You cannot afford to miss the proof of delivery as your claim would be denied without POD, even if everything else is perfect.
d. Use the right codes
Always use the correct HCPCS code for the product and link it with accurate diagnosis codes.
e. Monitor claim status
Your team should know what it takes to follow up regularly to identify any issues early, and they should act fast to correct and resubmit any denied claims.
Handling both rental and sales billing in-house can overwhelm the team. It takes skilled staff, advanced tools, and constant payer updates to stay on track. That’s why many providers work with a DME billing company. These experts manage everything—from checking documents and submitting claims to handling denials and AR follow-ups. They know payer rules, prevent denials, stay compliant with Medicare and Medicaid, automate rental tracking, and keep your claim rate clean. Outsourcing DME billing services saves time, reduces errors, and lets DME practices focus more on patient care than paperwork.
Are you already searching for a perfect DME billing company? Look no further than SunKnowledge Inc.
Related Reading: Why Proper Documentation Can Save You From Fraudulent DME Billing Services
SunKnowledge: The ideal DME billing destination
For nearly two decades, SunKnowledge has been making DME billing simple and efficient. We have already streamlined the perfect DME billing services for hundreds of clients across the nation and built a market-leading reputation in terms of accuracy and results. Our highly-skilled team knows what it takes to maintain the first-pass rate of 97% with 99% billing accuracy so that practices can always enjoy fewer denials and excellent cash flow throughout the time. With services starting at just $7 per hour, we help DME suppliers cut billing costs by up to 80%. Our proven success makes us one of the leading DME billing companies in the US. Fill out the Quick Connect form to see how we can simplify your DME billing and help you get paid faster.