Capped Rental Q & A
For Training Purposes Only
A Division of HealthNow New York Inc.
A CMS Contracted Carrier
1. When an assigned claim for the first month’s rental of a capped rental item is denied C0-
50, can the supplier take back the equipment from the beneficiary?
The ownership of the equipment remains with the supplier, as Medicare has made no payments
for the equipment. The patient is not responsible for payment due to the reason for the denial.
Since no payment is involved and Medicare has determined that the service is not medically
necessary, the supplier can take/pick up the equipment.
2. How does a supplier recover the cost of equipment that is under a rental agreement that
the patient loses, gives away, or is stolen from the patient, etc.?
Medicare has no involvement with such issues as described above. A claim for equipment,
which is the property of the supplier, and has not been returned to the supplier for one of the
above reasons, would be made in accordance with the laws and regulations that would be
applicable to the situation.
3. If the beneficiary moves to another state after the fifteenth month limit is completed, is
the supplier obligated to let the beneficiary keep the equipment in his/her home?
Responsibility for supplying equipment in the capped-rental category that has been rented for 15
continuous months remains with the supplier who rented the item in the fifteenth month of the
rental period. Responsibility for maintenance and service if the item also remains with that
supplier. A move by the Medicare beneficiary does not relieve the supplier who rented the item
in the fifteenth rental month of either responsibility. The responsible supplier may establish an
arrangement with a supplier located nearer the beneficiary’s new residence to furnish the actual
maintenance and service of the equipment.
4. If the patient dies after the supplier has billed for the monthly capped rental, does the
supplier return a prorated amount o