Modifier KH
Modifier KH Description and Billing Use
Plain-language description
DME rental/purchase sequence modifier.
How modifier KH is used
KH identifies an initial DMEPOS claim, purchase, or first rental month under applicable Medicare sequencing rules. CMS no longer requires KH on certain purchased NU or used-equipment claims, so verify the payment category and current Chapter 20 instructions instead of appending it to every initial DME claim.
Modifier KH questions
What does the KH modifier mean?
KH identifies an initial DMEPOS claim, purchase, or first rental month when current Medicare sequencing instructions require it.
What comes after KH for a rental?
For applicable rental sequences, KI generally identifies months two and three, while KJ identifies months four through fifteen for applicable PEN pump or capped-rental items.
Is KH required on every new DME purchase?
No. CMS removed the KH requirement from certain purchased NU and used-equipment claims. Verify the item's payment category and current instructions.
Before reporting this modifier
- 1. Confirm the current official or licensed definition and payer acceptance.
- 2. Identify the exact claim circumstance the modifier communicates.
- 3. Make the code, setting, related services, and medical record consistent.
- 4. Check NCCI, global surgery, component, DME, ABN, or drug rules that apply.
- 5. Do not append a modifier only to force an edit override.
This is a workflow summary, not a licensed CPT definition or claim-specific coding instruction. Verify the code set and payer rule effective for the date of service.