Durable medical equipment (DME) is primarily billed using temporary HCPCS Level II codes that begin with the letter K. These K-codes were created specifically for DME billing when no permanent national code exists to describe a particular item. Other temporary code categories, including Q-codes, G-codes, and S-codes, may also apply to DME-related items and services depending on the payer and the situation.
K-Codes: The Primary Temporary Codes for DME
K-codes are the temporary HCPCS codes designed exclusively for durable medical equipment. CMS established them for use by the DME Medicare Administrative Contractors (DME MACs) when permanent national codes don’t cover a specific product category or supply. Their main purpose is to let DME MACs build regional medical review coverage policies for items that haven’t yet received a permanent code.
A K-code fills the gap between when a new piece of equipment enters the market and when CMS assigns it a permanent code in the standard HCPCS system. Without K-codes, suppliers would have no way to bill for newer or specialized DME items, and MACs would have no mechanism to set coverage rules for them.
Other Temporary Code Categories That Apply to DME
While K-codes are the DME-specific temporary codes, several other temporary HCPCS ranges cover items and services that overlap with equipment billing:
- Q-codes (Q0035–Q9999): These cover a broad range of temporary needs including cast and splint supplies (Q4001–Q4051), ventricular assist devices (Q0477–Q0509), skin substitutes (Q4101–Q4433), and pharmacy dispensing fees. Many Q-coded items are supplies used alongside DME.
- G-codes: These represent temporary procedures and professional services. They sometimes appear in DME billing when a service component is tied to equipment setup, monitoring, or delivery.
- S-codes: These are temporary codes used by private insurers, not Medicare. When a commercial payer covers a DME item that lacks a permanent or K-code, an S-code may be assigned for that payer’s claims processing.
The distinction matters for billing. K-codes are recognized by Medicare’s DME MACs, while S-codes are not valid for Medicare claims. If you’re billing Medicare for equipment, you’ll use K-codes or permanent codes. If you’re billing a private payer, check whether they accept S-codes for the item in question.
How Temporary Codes Become Permanent
Temporary HCPCS codes do not have expiration dates. They remain active until the CMS HCPCS Workgroup decides to replace them with permanent codes or delete them. When a permanent code is created, the temporary code is deleted and cross-referenced to the new permanent code so that billing systems can map old claims to the updated identifier.
Permanent codes are updated once a year, with changes taking effect on January 1. Temporary codes, by contrast, can be added, changed, or deleted on a quarterly basis. CMS publishes updated code files in January, April, July, and October. This quarterly cycle gives the system flexibility to respond to new products or urgent program needs without waiting for the annual update.
K-Modifiers on Prosthetic and Orthotic Claims
The letter K also appears in a different context that’s easy to confuse with K-codes. When billing for lower limb prosthetic components, suppliers must add functional level modifiers labeled K0 through K4 to the claim line. These modifiers indicate the patient’s expected mobility level, from K0 (no ability to walk) through K4 (high-impact activity). They apply to permanent L-codes for knee, foot, ankle, and hip components, not to temporary K-codes.
Additional modifiers interact with DME coding. The KX modifier, for example, is added to prosthetic claim lines to certify that all coverage criteria in the relevant local coverage determination have been met and that documentation is on file. The GY modifier flags items that are statutorily non-covered, such as prosthetic donning sleeves billed under L7600.
Documentation for DME Claims
Regardless of whether a claim uses a temporary or permanent code, suppliers must keep a detailed written order from the treating physician on file and make it available to the MAC on request. For claims with dates of service on or after January 1, 2023, suppliers no longer need to submit a Certificate of Medical Necessity (CMN) or DME Information Form (DIF) with the claim itself. CMS eliminated that requirement because electronic filing and improved medical records management made those forms redundant. Claims submitted with CMNs or DIFs attached after that date are now rejected and returned.
For replacement equipment, the documentation rules depend on the reason. If equipment was lost or irreparably damaged, the MAC can approve the replacement based on the original order as long as it still reflects the patient’s needs. If the replacement is due to normal wear or a change in condition, a current physician’s order is required.
Finding Current Temporary Codes
CMS publishes the full HCPCS Level II code set as a downloadable public use file on its website, updated quarterly. The file title includes the effective date, so you can verify you’re working with the most current version. The January 2026 file, for example, was last updated on January 12, 2026. Checking these files regularly is the most reliable way to confirm whether a temporary K-code or Q-code is still active, has been cross-referenced to a new permanent code, or has been deleted.