DME MAC Jurisdiction C - DME Facts
JC processes FFS Medicare DME claims for Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia and West Virginia
Who were the former contractors in this jurisdiction?
Learn about the former contractors in this jurisdiction at Archives: DME MAC Jurisdiction C.
Current Maps and Lists
To find out who the current A/B and DME MACs are, use these maps and lists to help you determine which MAC is of most interest to you.
DME MACs
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS. Learn more about the DME MAC in each jurisdiction.
When is prior authorization required for HCPCS?
As of December 1, 2020, prior authorization of these codes is required for all states and territories. All new rental series claims for HCPCS Codes K0813-K0829, K0835-K0843, and K0848-K0864 with a date of delivery on or after July 22, 2019 must be associated with a prior authorization request as a condition of payment.
When will CGS begin accepting prior authorization requests?
CGS began accepting prior authorization requests on August 18, 2020. Will begin for items furnished on or after December 1, 2020 and expands required prior authorization of these codes to all of the remaining states and territories. The DME MACs began accepting prior authorization requests for the remaining states and territories on November 17, ...
How long is an affirmed ADMC valid?
An affirmed ADMC decision means beneficiary meets medical necessity requirements for Medicare. An affirmed ADMC is valid for six months from date of the decision. Any claim eligible for this program must be prior authorized before delivery of the item or it will be denied as prior authorization is a condition of payment.