1

Appendix G

List of Outpatient Hospital Unbundled Durable Medical Equipment Codes

For the Outpatient Hospital Durable Medical Equipment (DME) items that are unbundled in the Enhanced Ambulatory Patient Group (EAPG) payment methodology and their corresponding codes for use in billing, please refer to the Outpatient Hospital Unbundled DME Codes.

Appendix G Revisions Log

Revision Date Appendix Made by
1/27/2020 Initial posting of manual Gainwell
1/26/2022 Update of manual Gainwell
6/8/2022 Converted PDF to web page HCPF
1/26/2023 Update of manual Gainwell