New Jersey: New DME claim criteria

Last modified: June 30, 2021

Effective Aug. 1, 2021, claims submitted to UnitedHealthcare Community Plan of New Jersey related to the following durable medical equipment (DME) will be denied if the claims don’t meet the DME Medicare Administrative Contractor (MAC) criteria:

• Knee braces and orthoses
• Positive airway pressure (PAP) supplies
• Oxygen tanks
• Urinary catheters

We reimburse DME unit limits based on the UnitedHealthcare Community Care of New Jersey DME MAC criteria.  

PCA-1-21-02136-C&S-NEWS