Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 322.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Section

322.01: General Provisions 322.02: General Definitions 322.03: General Rate Provisions 322.04: Filing and Reporting Requirements 322.05: Add-on and Supplemental Payment Provisions 322.06: Allowable Fees and Rate Schedule 322.07: Severability

322.01: General Provisions

(1) Scope and Purpose. .00 governs the determination of rates of payment to be used by all governmental units in making payment to eligible providers of durable medical equipment and supplies provided to publicly aided individuals. The rates set forth in 101 CMR 322.00 do not apply to individuals covered by the Workers' Compensation Act, M.G.L. c. 152. Rates for services rendered to such individuals are set forth in 114.3 CMR 40.06: Fees.

(2) Applicable Dates of Service. Rates contained in .00 apply for dates of service provided on or after March 1, 2026, unless otherwise specified.

(3) Coverage. .00 and the rates of payment contained herein apply to the following categories: (a) the purchase or rental of durable medical equipment; (b) the purchase of medical and surgical supplies; (c) the purchase or rental of seating, positioning, mobility systems, and related accessories; (d) the purchase or rental of prescribed oxygen delivery systems and respiratory therapy devices and related supplies; (e) the purchase or rental of intravenous and enteral therapy, equipment, and related supplies and services; and (f) the repair or modification of the above listed types of equipment.

(4) Exclusions. .00 and the rates of payment contained herein do not apply to the following services: (a) respiratory therapy services rendered by a qualified respiratory therapist; (b) all services included in the reimbursement to an institutional provider; and (c) all services for inpatients at a facility licensed as an acute or chronic disease and rehabilitation hospital.

(5) Disclaimer of Authorization of Services. .00 is not authorization for nor approval of the procedures for which rates are determined pursuant to .00. Governmental units that purchase care are responsible for the definition, authorization, and approval of care to publicly aided individuals.

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

(6) Coding Updates and Corrections. EOHHS may publish procedure code updates and corrections in the form of an administrative bulletin. The publication of such updates and corrections will list (a) codes for which the code numbers only changed, with the corresponding crosswalk; (b) codes for which the code numbers remain the same but the description has changed; (c) deleted codes for which there is no crosswalk; and (d) for entirely new codes that require new pricing, EOHHS may list these codes and price them at a percentage of the prevailing Medicare fees as described in .01(6)(d) and .03(16), when Medicare fees are available. When Medicare fees are not available or when otherwise designated by EOHHS as described in .03(16), EOHHS may apply individual consideration, adjusted acquisition cost plus a standard markup, or specify a fixed rate as described in .01(7)(e) in reimbursing for these new codes until appropriate rates can be developed.

(7) Administrative Bulletins. EOHHS may issue administrative bulletins to (a) clarify its policy on substantive provisions of .00; (b) specify any durable medical equipment or medical supplies subject to a preferred supplier contract or contracts between a supplier and a governmental unit or units, the governmental unit(s) and eligible providers subject to the contract, the duration of the preferred supplier contract, the prices at which such durable medical equipment or medical supplies will be available to eligible providers (as defined by the preferred supplier contract), the rates which eligible providers (as defined by the preferred supplier contract) will be paid by the relevant governmental unit(s) for such durable medical equipment or medical supplies, and any other information deemed necessary by EOHHS; (c) specify any durable medical equipment or medical supplies subject to a rebate agreement or agreements between a manufacturer and a governmental unit or units, the governmental unit(s) and eligible providers subject to the agreement, the duration of the rebate agreement, the rates which will be paid to eligible providers (as defined by the applicable rebate agreement) by the relevant governmental unit(s) for the specified durable medical equipment or medical supplies, and any other information deemed necessary by EOHHS; (d) specify upward adjustments to the standard markup defined at .02 for codes when a governmental unit determines that the standard markup requires adjustment to account for increased provider costs and/or a shift in utilization patterns or to maintain access to care; (e) specify a fixed rate for codes which do not have a Medicare rate or would otherwise be priced at individual consideration based on an adjusted acquisition cost when a fixed rate can be determined by using a comparison of industry rates including Medicare crossover payments, other state Medicaid payment rates and Medicaid third-party liability/private insurance rates; (f) specify upward adjustments to historical fixed rates which do not have a Medicare rate for codes when a governmental unit determines that the historical fixed rate requires adjustment to account for increased provider costs and/or a shift in utilization patterns or to maintain access to care; (g) specify any durable medical equipment or medical supplies subject to the pricing methodology described at .03(20);

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

(h) describe conditions of payment for an add-on payment for certain mobility system repairs for MassHealth members under .05(1); and (i) describe conditions of payment for supplemental payments for certain patient lift systems or other designated services under .05(2) for MassHealth members who are eligible for both Medicare and MassHealth services (dual eligible members).

322.02: General Definitions

Terms, as used in .00, have the meanings set forth in .02.

Accessories. Products that are used primarily and customarily to modify or enhance the usefulness or functional capability of durable medical equipment and that are generally not useful in the absence of durable medical equipment.

Adjusted Acquisition Cost (AAC). The price paid to a supplier by an eligible provider for durable medical equipment, medical and surgical supplies, customized equipment, oxygen and respiratory therapy systems or devices and related supplies, enteral and intravenous therapy, equipment, and related supplies excluding all associated costs such as, but not limited to, shipping, handling, sales tax, and insurance costs. The adjusted acquisition cost must reflect all discounts, including but not limited to manufacturer, dealer, trade, and volume discounts, including rebates, in whatever form, extended to the provider for the purchase of the covered item. The only discount that does not have to be passed on to the governmental unit is the amount allowed to the provider that is attributable to a timely payment to the manufacturer or supplier, not to exceed 5% of the AAC. The methodology for pricing at AAC is set forth in 101 CMR 322.03(17).

Advertised Price. The price of a product or service as displayed or announced in a print, radio, television, or online advertisement.

Assistive Technology Professional (ATP). An individual with experience in assistive/rehabilitation technology and certification by the Rehabilitation Engineering and Assistive Technology Society of North America who analyzes the equipment needs of persons with disabilities, assists in the selection of equipment, and trains the person with a disability on how to use the specific equipment. This equipment may include manual and power wheelchairs, seating and alternative positioning, ambulation assistance, environmental control, alternate computer access, augmentative and alternative communication devices, and products of daily living.

Capped Rentals. Capped rental items are designated with the modifiers KH, KI, and KJ in the “code” column of .06 and are rented for a maximum period of 13 months, at which point the provider stops billing and turns over ownership and all warranty information to the consumer. The provider may bill for repairs as needed to maintain the proper working condition of the equipment for the consumer's use after ownership turns over to the consumer.

Center. The Center for Health Information and Analysis established under M.G.L. c. 12C.

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Cross-walk. A cross-reference in which a code is deleted and replaced with another code.

Customized Equipment. Durable medical equipment that (a) is uniquely constructed, adapted, or modified solely for the full-time use of the patient for whom it is purchased; (b) is made to order or adapted to meet the specific needs of the patient; and (c) the unique construction, adaptation, or modification of which permanently precludes the use of such equipment by another individual.

Durable Medical Equipment (DME). Equipment that (a) is used primarily and customarily to serve a medical purpose; (b) is generally not useful in the absence of disability, illness and injury; (c) can withstand repeated use over an extended period of time; and (d) is appropriate for home use (any setting in which normal life activities take place).

Eligible Provider. Any person, partnership, corporation, or other entity that is authorized by the Commonwealth of Massachusetts to engage in the business of furnishing durable medical equipment, medical and surgical supplies, customized equipment, oxygen or respiratory therapy equipment, mobility systems, intravenous and enteral therapy equipment, and related supplies and services and who meets such conditions of participation as may be adopted by a governmental unit.

EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A.

Governmental Unit. The Commonwealth, any department, agency, board, or commission of the Commonwealth, and any political subdivision of the Commonwealth.

Home Infusion Therapy (HIT) Services. The administration of medications to a patient in a home setting using delivery devices through intravenous, subcutaneous, or epidural routes. Drug therapies commonly administered include antibiotics, chemotherapy, pain management, parenteral nutrition, and immunoglobulin.

Individual Consideration (IC). Items for which there is no specified rate or when otherwise designated by EOHHS are individual consideration and are subject to the following procedure. The purchasing governmental unit analyzes the eligible provider's report of services submitted before making a determination. Providers must keep adequate records to substantiate their IC claims and must provide these documents, including a copy of the current invoice, to the purchasing agency. The methodology for pricing at IC is set forth in .03(19).

Liquid Oxygen System. Respiratory therapy equipment utilizing liquid oxygen.

Medical Supplies. Consumable or disposable supplies or devices for home use, necessary for the treatment of a specific illness, injury, disease, or disability, including, but not limited to, test strips, syringes, ostomy products, and surgical items that are

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

(a) required to address an individual medical disability, illness, or injury; (b) cannot withstand repeated use by more than on individual; (c) generally not useful in the absence of illness or injury; (d) consumable or disposable; and (e) appropriate for use in any setting in which normal life activities take place.

Mobility System. A manual or power wheelchair or other wheeled device, such as a scooter, including a base, a seating system, its components, accessories, and modifications.

Oxygen. Gaseous or liquid medical grade oxygen that conforms to United States Pharmacopeia Reference Standards.

Oxygen Delivery Systems. A comprehensive oxygen service that includes, but is not limited to the gaseous/liquid oxygen, oxygen generating device and related delivery systems container or cylinder, manifold systems whenever high volume oxygen is used, stand, cart, walker/stroller, supply reservoir, contents indicator, regulator with flow gauge, humidification devices, cannulas, masks, and special oxygen administration device, tubing, and refill adapter.

Oxygen Generating Device. Any device suitable for domiciliary use that produces oxygen by any chemical or physical means, such as but not limited to, oxygen concentrators and oxygen enrichers, and that conforms to such standards as may be required by federal and state governmental units.

Patient Lift System. A hoist, jack hoist, or hydraulic lift which may be either a sling lift (or Hoyer Lift, a brand name, used for patients whose mobility is limited) or sit-to-stand lift, which may be mobile (floor) lifts or overhead lifts (suspended from ceiling-mounted or overhead tracks).

Positioning System. Equipment prescribed to meet a medical need and intended to provide an alternative position to the seated wheelchair position.

Preferred Supplier Contract. A contract between a supplier of durable medical equipment or medical supplies and EOHHS or another governmental unit under which the supplier agrees to supply specified durable medical equipment or medical supplies at specified rates to certain eligible providers defined by the contract.

Prescribing Provider. The member’s physician, nurse practitioner, clinical nurse specialist, or physician’s assistant who prescribes and writes the prescription.

Publicly Aided Individual. A person for whose medical and other services a governmental unit is in whole or in part liable under a statutory public program.

Rate. See .03 and .06.

Rebate Agreement. An agreement by which a manufacturer of durable medical equipment or

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

medical supplies agrees to pay EOHHS or another governmental unit a rebate related to payments for specified durable medical equipment or medical supplies by the relevant government unit or units to certain eligible providers defined in the agreement.

Recall. An action taken by the manufacturer to retrieve, replace, or repair dangerous or defective DME, whether or not such action is taken at the direction of the Food and Drug Administration (FDA).

Request for Prior Authorization. A request by a provider, as required by the governmental unit, that the government unit determine the medical necessity of specified equipment or supplies for a particular individual. The provider must submit any such request to the governmental unit in accordance with all applicable laws, regulations, and policies.

Respiratory Therapy Devices and Supplies. Those modalities and necessary ancillary equipment used in the care and treatment of pulmonary insufficiencies from whatever cause as may be ordered by the prescribing provider for their therapeutic and remedial effect, and that meet such standards as may be required by federal or state governmental units. Respiratory therapy devices include, but are not limited to, the complete device and related delivery system accessories including regulator with flow gauge, humidification and heating units, filters, cannulas, masks, and special administration device tubing and adapters.

Retail Price. The total price charged for a product sold to a customer, which includes the manufacturer's cost plus a retail markup.

Sale Price. The price at which something sells or is sold after its price has been reduced.

Seating Systems. A seated positioning system, including its components, accessories, and modifications, which may be attached to a base wheelchair and is designed to meet the individualized medical needs of the patient.

Shelf Price. The sign or tag placed by an authorized person at each point of display which clearly sets forth the retail price of the consumer item.

Standard Markup. Except where otherwise indicated in an applicable section of 101 CMR 322.03, the standard markup for durable medical equipment, medical and surgical supplies, and oxygen and respiratory equipment that is applied to the AAC, net of any discounts as specified in the definition of AAC at .02, and paid to a supplier by an eligible provider cannot exceed (a) the applicable standard markup set forth below for items for which the eligible provider received a timely payment discount less than or equal to 5% will be applied to the AAC, net of costs and discounts to be excluded under the definition of AAC at .02 1. 20% for medical and surgical supplies and disposable items; 2. 25% for enteral formulas used to replace fluid electrolytes; 3. 35% for enteral and parenteral solutions; 4. 35% for wheeled mobility system equipment and accessories, as defined in 101 CMR

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

322.02, and for certain patient lift systems; and 5. 30% for all other equipment, customized tracheostomy supplies, and certain diabetic equipment and supplies. (b) the applicable standard markup set forth below for items for which the eligible provider received a timely payment discount greater than 5%, will be applied to the AAC net of costs and discounts to be excluded under the definition of AAC at .02 1. 25% for medical and surgical supplies and disposable items; 2. 30% for enteral formulas used to replace fluid and electrolytes; 3. 40% for enteral and parenteral solutions; 4. 40% for wheeled mobility system equipment and accessories, as defined in 101 CMR 322.02, and for certain patient lift systems; and 5. 35% for all other equipment, customized tracheostomy supplies, and certain diabetic equipment and supplies.

Used Equipment. Any item that has been previously purchased or rented, including equipment that was (a) used by a patient for a trial period; (b) used by the supplier as a demonstrator; or (c) rented by a patient who now wants to buy it.

Usual and Customary Charge. The lowest price that an eligible provider charges to any payer in Massachusetts other than for publicly aided individuals for the same equipment or item, including but not limited to the shelf price, sale price, or advertised price.

322.03: General Rate Provisions

(1) Purchase or Rental of Durable Medical Equipment, Medical and Surgical Supplies. Payment to an eligible provider for the purchase of the above services will be the lowest of (a) the eligible provider's usual and customary charge; (b) the preferred supplier rate published in an administrative bulletin pursuant to 101 CMR 322.01(7) plus an additional percentage handling fee if applicable; (c) the rebate agreement rate published in an administrative bulletin pursuant to 101 CMR 322.01(7); or (d) such schedule of allowable fees set forth in .06.

(2) Direct Service Component (RE Units). Payment to an eligible DME provider for the initial evaluation of customized seating, positioning, mobility systems, installation of customized movable and fixed patient lift systems, and assembly of at the preapproved levels of time and complexity as defined below. (a) RE 1-5 - Specialized (1-5 hours). (b) RE 6-10 - Intermediate - More time and complexity with multiple trials of equipment, custom fabrication of some parts (6-10 hours). (c) RE 11-15 - More time and complexity with multiple trials of equipment, high level of complexity in custom fabrication of some parts, and may involve use of components from one or more manufactures (11-15 hours).

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

(d) RE 16-23 - Complex - More time and complexity with multiple trials of equipment, very high level of complexity and may involve extensive time for trials of multiple products, extended amount of custom fabrication, or interactions with several professionals - physicians, therapists, teachers (16-23 hours). (e) RE units will be billed using the K0739-U5 code and modifier combination.

(3) Rental of Oxygen Delivery Systems. (a) The monthly rate of reimbursement for comprehensive oxygen services includes but is not limited to the following services: 1. the gaseous/liquid oxygen, oxygen generating device and related delivery system container or cylinder, manifold systems whenever high volume oxygen is used, stand, cart, walker/stroller, supply reservoir, contents indicator, regulator with flow gauge, humidification devices, cannulas, masks, and/or special oxygen administration device, tubing, and refill adapter; 2. the complete device, cleaned and sterilized when appropriate, in proper working condition, and any maintenance, service, and repair of unit as needed including replacement of defective parts. The routine replacement of parts, including disposable parts, occurs as needed or according to manufacturer's specifications; 3. delivery of the gaseous oxygen inclusive of 24-hour service costs; 4. back-up gaseous oxygen and related equipment and supplies; and 5. demonstration and instruction of safe usage of equipment, delivery, and set-up. (b) Payment to an eligible provider for the rental of oxygen generating devices and oxygen delivery systems will be the lower of 1. the eligible provider's usual and customary charge; or 2. such schedule of allowable fees set forth in .06. (c) Payment to an eligible provider for the rental of oxygen delivery systems provided to publicly aided individuals in a nursing facility must be the lower of 1. the eligible provider's usual and customary charge; or 2. 90% of the schedule of allowable fees set forth in .06.

(4) Purchase and Rental of Respiratory Therapy Devices. (a) Respiratory Therapy Devices (Purchase). 1. The purchased respiratory therapy device includes but is not limited to the following services: a. the complete device, new at the time of purchase, and in proper working condition; b. service and repair of the unit as needed including replacement of defective parts. The routine replacement of parts, including disposable parts, occurs as needed or according to manufacturer's specifications. These can be billed for purchased devices unless otherwise specified under warranty; c. the device and related delivery system accessories including regulator with flow gauge, humidification and heating units, cannulas, masks, or special administration device, tubing, and adapters; d. delivery of the device inclusive of 24-hour service costs; and e. demonstration and instruction of safe usage of equipment, delivery, and set-up.

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

2. Payment to an eligible provider for the purchase of respiratory therapy devices must be the lower of a. the eligible provider's usual and customary charge; or b. such schedule of allowable fees set forth in .06. (b) Respiratory Therapy Devices (Rental). 1. The monthly rental of respiratory therapy devices includes but is not limited to a. the complete device, cleaned and sterilized when appropriate, in proper working condition, and any maintenance, service, and repair of unit as needed including replacement of defective parts. The routine replacement of parts, including disposable parts, occurs as needed or according to manufacturer's specifications; b. the device and related delivery system accessories including regulator with flow gauge, humidification and heating units, filters, cannulas, masks, and special administration device, tubing, and adapters; c. delivery of the device inclusive of 24-hour service costs; d. monthly cleaning and check of unit; e. back-up respiratory therapy equipment; and f. demonstration and instruction of safe usage of equipment, delivery, and set-up. 2. Payment to an eligible provider for the rental of the above services must be the lower of a. the eligible provider's usual and customary rental fees and terms; or b. the fees set forth in .06. 3. Payment to an eligible provider for the rental of respiratory therapy devices provided to publicly aided individuals in a nursing facility must be the lower of a. the eligible provider's usual and customary rental fees and terms; or b. 90% of the schedule of allowable fees set forth in .06.

(5) General Rate Provisions for the Purchase of Home Infusion Therapy Services. (a) Payment to an eligible provider for home infusion therapy services must be the lower of 1. the eligible provider's usual and customary charge; or 2. such schedule of allowable fees set forth in .06. (b) For services designated IC, the adjusted acquisition costs to the eligible provider for items consumed per day plus a 20% markup plus $8.00 for professional service. (c) Included in the per diem fees are all necessary supplies, equipment, and administrative services. Payment for pharmacy items and services will be determined under the provisions of 101 CMR 331.00: Prescribed Drugs. Payment for nursing services will be determined according to purchaser specifications under the provisions of 101 CMR 350.00: Rates for Home Health Services. Parenteral and enteral nutrition formula must be billed separately.

(6) Option to Purchase. Governmental units may reserve the right to purchase, at their option, durable medical equipment and respiratory therapy equipment that is being supplied on a monthly rental basis to publicly aided individuals. (a) If covered, items can be purchased new or used; however, total payments cannot exceed the fee for purchase as new. (b) If covered, items can be purchased at 100% of the fee. (c) If covered, items that are usually purchased and fall into the inexpensive and frequently

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

purchased item category can be rented for 10% of the purchase price, not to exceed 10 months of rental and the fee for purchase as new. (d) If covered, used equipment can be rented at 10% of 75% of the fee for purchase as new. (e) If covered, used equipment can be purchased at 75% of the fee for purchase as new. (f) Capped rental items that are purchased prior to the end of the 13-month capped rental period are purchased at an amount not to exceed 13 months of rental.

(7) Condition of Rental Equipment Upon Delivery. All equipment that is rented on a monthly basis must be clean and in proper working condition when delivered. Respiratory therapy equipment provided on a rental basis must be in proper working condition and be free from contaminating agents. Tubing and masks must be new or unused, in proper working condition, and free from contaminating agents.

(8) Condition of Purchased Equipment Upon Delivery. All equipment that is purchased must be new and unused, clean, in proper working condition, free from defects, and meet all implied and expressed warranties. In the case of rental items purchased under .03(6), Option to Purchase, the equipment must be in proper working condition and be free from contaminating agents. Tubing and masks must be new or unused, in proper working condition, and free from contaminating agents. (See .03(7): Condition of Rental Equipment Upon Delivery.)

(9) Rental Services. Unless otherwise authorized under .00, rental rates include the cost of servicing, repairs, and maintenance including replacements of defective parts and disposable items.

(10) Delivery, Installation, and Patient Instructional Time. Unless otherwise authorized under .00, the maximum allowable fee for purchase or rental of durable medical equipment must include the following where required and appropriate: (a) cost of the provider's delivery to the inside of the recipient's residence and, when appropriate, to the room in which the equipment will be used; including allowance of the delivery via UPS or a similar delivery service with a copy of the proof of delivery slip signed by the recipient or recipient's caregiver, or noted by the company driver when a signature is unobtainable, and/or a copy of the delivery service company log (route) sheet; (b) installation and setup of the equipment; and (c) instruction of the recipient in the safe usage of the equipment.

(11) Terms and Warranties. Other terms and warranties included under the rate provisions of .00 notwithstanding, all terms, express and implied warranties, warranties of repair and service, or any other warranties, which are extended to a specific recipient or customarily extended to any payor will apply to purchases or rentals made under authority of 101 CMR 322.00.

(12) Repairs, Maintenance Service, Replacement Parts, and Professional Services. All rates for repair and maintenance services to purchased equipment that require repair, replacement parts and/or the use of technical components (services) can be found within .06.

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

(13) Modifiers. The following list of letter modifiers must be added, where appropriate, to HCPCS procedure codes to determine the percent fee to be paid on claims. Refer to purchasers' manuals for specific coding instructions. (a) Capped rental coding modifiers are as follows. 1. KH–Initial claim, either rent (first month) or purchase. 2. KI–Second or third month rental. 3. KJ–Rental months four to 13. (b) Additional modifiers are as follows 1. A1–Dressing for one wound. 2. A2–Dressing for two wounds. 3. A3–Dressing for three wounds. 4. A4–Dressing for four wounds. 5. A5–Dressing for five wounds. 6. A6–Dressing for six wounds. 7. A7–Dressing for seven wounds. 8. A8–Dressing for eight wounds. 9. A9–Dressing for nine or more wounds. 10. AU–Item furnished in conjunction with a urological, ostomy, or tracheostomy supply. 11. AV–Items furnished in conjunction with prosthetic/orthotic. 12. AW–Item furnished in conjunction with a surgical dressing. 13. AX–Item furnished in conjunction with dialysis services. 14. AY–Item or service furnished to an end-stage renal disease (ESRD) patient that is not for the treatment of ESRD. 15. BA–Item furnished in conjunction with parenteral enteral nutrition (PEN) services. 16. BO–Orally administered nutrition, not by feeding tube. 17. CS–Item or service related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the Gulf of Mexico, including but not limited to subsequent clean-up activities. 18. GA–Waiver of liability statement issued as required by payer policy, individual case. 19. GS–Dosage of epo or darbepoietin alfa has been reduced 25% of preceding month's dosage. 20. GU–Waiver of liability statement issued as required by payer policy, routine notice. 21. GX–Notice of liability issued, voluntary under payer policy. 22. JB–Subcutaneous administration. 23. KC–Replacement of special power wheelchair interface (applicable to codes E2320- E2330). 24. KF–item designated by FDA as class III device. 25. KK–DMEPOS item subject to DMEPOS competitive bidding program number 2. 26. KL–DMEPOS item delivered via mail. 27. KO–Single drug unit dose formulation. 28. KP–First drug of a multiple unit dose formulation. 29. KQ–Second or subsequent drug of a multiple drug unit dose formulation. 30. KR–Rental item for a partial month. 31. KS–Glucose monitor supply for diabetic beneficiary not treated with insulin.

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

32. KX–Specific required documentation on file (member treated with insulin). 33. KU–DMEPOS item subject to DMEPOS competitive bidding program #334. 34. LL–Lease/rental with option to purchase. 35. LT–Left side (used to identify procedures performed on the left side of the body). 36. MS–Six-month maintenance and servicing fee for reasonable and necessary parts. and labor which are not covered under any manufacturer or supplier warranty. 37. NU–New equipment. 38. QF–Prescribed amount of oxygen exceeds 4 liters per minute (LPM) and portable oxygen is prescribed. 39. QG–Prescribed amount of oxygen is greater than 4 liters per minute (LPM). 40. RA–Replacement of a DME item (for use only with K0108 for direct service component for customization purposes, MassHealth only). 41. RB–Replacement of a part of a DME furnished as part of a repair. 42. RR–Rental of durable medical equipment and oxygen/respiratory therapy equipment. 43. RT–Right side (used to identify procedures performed on the right side of the body). 44. SC–Medically necessary service or supply. 45. SD–Services provided by registered nurse with specialized, highly technical home infusion training. 46. TW when used in conjunction with code A4210: Back-up equipment; when used. with codes for alternative and augmentative communication devices: MassHealth only-- non-dedicated alternative and augmentative communication devices. 47. U1–Medicaid level of care 1 (used only for nonstandard power wheelchair trays and patient lift systems). 48. U2–Medicaid level of care 2 (first six months of rental, volume/pressure ventilator). 49. U3–Medicaid level of care 3 (used for supplies for maintenance of insulin infusion catheter for MassHealth or to identify a Corrective Mobility Repair add-on payment when used in conjunction with HCPCS code K0739). 50. U4–Medicaid level of care 3 (used only for supplies for maintenance of insulin infusion catheter for MassHealth). 51. U5–used for requesting direct service components for customized mobility services. requiring ATP RE-1 through RE 23, for installation of patient lift systems RE-1 through RE-23, and setup of safety beds RE-1 through RE-5. 52. U6–may be used when requesting certain incontinent products or used in combination with relevant HCPCS code (K0739) when requesting labor when repairing a member’s serviceable retired power wheelchair. 53. U7–to be used in combination with HCPCS code (K0739) to bill for wheelchair repair evaluation. 54. U8–Informational modifier to be used in combination with HCPCS codes (S5160, S5161RR, S5162, and S5162TW) when the unit is a cellular network Personal Emergency Response System. 55. UA–Medicaid level of care 10 (used for adults for safety beds and customized tracheostomy supplies). 56. UB–Medicaid level of care 11 (repair, RTS providers only). 57. UC–Medicaid level of care 12 (used for pediatric specialized equipment only). 58. UD–Medicaid level of care 13 (bariatric equipment).

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

59. UE–Used durable medical equipment.

(14) Shop Repair of Purchased Equipment and Rental Equipment. (a) Whenever a repair service for purchased equipment that is unusable or requires removing the equipment from the residential setting to the shop, the eligible provider must supply a substitute unit in proper working condition and comparable in all respects to the unit to be serviced. The provision of the substitute equipment will be on a rental basis; the rental rate will be established utilizing the one-month KJ fee on file for the primary HCPCS being repaired on a one-time per repair basis. (b) No payment for rental of substitute equipment will exceed the one-month rental fee, per repair. (c) Whenever a repair service for rental equipment requires the removal of the equipment from the residential setting, the eligible provider must supply a substitute unit in proper working condition and comparable in all aspects to unit to be repaired. No extra rental charge will be allowed for this substituted equipment.

(15) Recall Provisions. Whenever purchased or rental equipment is subject to recall, the provider will fully address the recall as specified in the manufacturer’s recall instructions. For recalls of potentially dangerous or defective DME that predictably could cause serious health problems or death, the DME provider must provide the member with a copy of the Recall Notice and fully address the Recall as specified in the Recall instructions no later than five business days from the date the DME provider receives the Recall Notice. Any costs not covered by the manufacturer or other third party for activity associated with amelioration, repair, or replacement of recalled equipment is included in the general rate provisions for each category of equipment in .03.

(16) General Rate Provisions for Pricing of New Codes. As described in .01(6), EOHHS may publish new procedure codes in the form of an administrative bulletin and set fees as follows: (a) when Medicare fees are available, except as otherwise specified in .03(16) 1. 100% of Medicare for a. specialized wheeled mobility equipment and accessories b. first six months’ rental for volume ventilators c. certain diabetic equipment and supplies d. certain patient lifts and accessories e. elevating leg rests 2. 85% of Medicare for all other items, including speech generating devices and certain oxygen equipment and supplies. (b) when Medicare fees are not available and for certain durable medical equipment or medical supplies, apply IC at adjusted acquisition cost plus the standard markup as defined in .02. MassHealth may also specify a fixed rate determined by using comparison of industry rates including Medicare crossover payments, other state Medicaid payment rates, and TPL/private insurance rates.

(17) AAC Methodology and Documentation.

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(a) The eligible provider must accurately indicate the amount of any discounts set forth at .02 and the order in which any discounts were applied. The provider must maintain documentation evidencing the amount and application of discounts. (b) Current Catalogue Price. The AAC to the eligible provider must not exceed the manufacturer's current catalogue price. Eligible providers must maintain documentation of the current catalogue price or submit documentation of the Current Catalogue Price with a claim or invoice for any item priced using the AAC methodology. (c) Documentation of the Purchase Price and Timely Payment Discount for Items Not Subject to Prior Authorization (PA). For items not subject to PA and purchased in advance of filing a claim, the AAC must be evidenced by the purchase price to the provider from the manufacturer for the equipment listed on a copy of a current receipted invoice from the manufacturer. The invoice and supporting documentation submitted with claims to the applicable governmental unit must indicate 1. the date of the timely payment; and 2. the amount and percentage of the timely payment discount. Providers must maintain documentation evidencing the percentage of the AAC that the provider’s supplier allows as a timely payment discount, and how the supplier defines “timely payment” for any such discount. (d) Documentation of amount and percentage of timely payment discount for items subject to PA. For items subject to PA and not purchased in advance of filing a claim, the eligible provider must include the following with the PA request: 1. a copy of the quote from the manufacturer; 2. supporting documentation of cost and discounts; 3. documentation of the amount and percentage of the timely payment discount. The claim must reflect the actual purchase price to the provider from the manufacturer if less than the quote submitted for prior authorization. Manufacturers enrolled as DME providers must submit documentation that demonstrates the retail/catalogue/list price along with all discounts that would be passed on to a provider; and 4. Providers are required to submit invoices on initial claims but are not required to submit invoices on subsequent claims during a PA period if the price established on the PA has not changed.

(18) The Methodology for Pricing Capped Rentals. Purchase rates for items, including power wheelchairs, otherwise designated in .06 with the capped rental modifiers KH, KI, and KJ are indicated with the modifiers NU and UE. The NU rates are established as a percentage of Medicare’s rates, pursuant to .01(5) and .03(16). The purchase of capped rental items, including power wheelchairs, otherwise designated with the modifiers KH, KI, and KJ for capped rental, will be no more than the sum of the capped rental methodology applied for 13 months. See .03(14). (a) The methodology for capped rental payment of items other than power wheelchairs designated with the modifiers KH, KI, and KJ is as follows: 1. for months one through three of rental (KH, KI), 10% of the new purchase fee; 2. for months four through 13 of rental (KJ), payment at 75% of the amount for months one through three; and 3. no further monthly payments after the 13th month.

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(b) The methodology for payment of power wheelchairs designated with the modifiers KH, KI, and KJ is as follows: 1. for the first three months of rental (KH, KI), 15% of the new purchase fee; 2. for months four through 13 (KJ), payment at 40% of the amount for months one through three; and 3. no further monthly payments after the 13th month (19) Except where otherwise stipulated in .03, payment to an eligible provider for IC will be the lower of (a) the eligible provider’s usual and customary charge; or (b) the following rate, as applicable: 1. for purchases of supplies and disposable items, the adjusted acquisition cost to the eligible provider plus the applicable standard markup of 20% or 25%, as defined in 101 CMR 322.02; 2. for purchases of enteral and parenteral solutions, the adjusted acquisition cost to the eligible provider plus the applicable standard markup of 25% or 30%, as defined in 101 CMR 322.02; 3. for purchases of wheeled mobility system equipment and related accessories, and for certain patient lift systems, the adjusted acquisition cost to the eligible provider plus the applicable standard markup of 35% or 40%, as defined in .02; 4. for purchases of other new equipment or customized tracheostomy supplies or certain diabetic equipment and supplies, the adjusted acquisition cost to the eligible provider plus the applicable standard markup of 30% or 35%, as defined in .02; 5. for rental items, one-tenth of the fee paid for the item if purchased new; 6. for capped rental items, refer to the methodology within the definition of “capped rental” in .02; 7. for used items, 75% of the fee paid for the item if purchased new; 8. for covered drugs, the adjusted acquisition cost, as defined in .02; and 9. for home infusion therapy, the adjusted acquisition cost to the eligible provider for items consumed per day plus a 20% markup plus $8.00 for professional services, as indicated in .03(5)(b).

(20) Methodology for Certain Durable Medical Equipment or Medical Supplies Purchased at Pharmacies. Payments to pharmacies billing through the pharmacy online processing system for designated durable medical equipment or medical supplies will be the lower of wholesale acquisition cost and usual and customary charge, as defined in 101 CMR 331.00 (with any references to “prescription drugs” changed, for purposes of .03 (20), to “durable medical equipment” or “medical supplies,” as applicable). EOHHS will designate durable medical equipment or medical supplies subject to this pricing methodology in administrative bulletin or other appropriate written issuance.

322.04: Filing and Reporting Requirements

(1) Required Reports. Reporting requirements are governed by 957 CMR 6.00: Cost Reporting Requirements. In addition, each eligible provider that receives an add-on or supplemental payment pursuant to .05 must file or make available all records and information

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necessary to demonstrate compliance with conditions of payment upon EOHHS request, including documentation of the uses of such payments.

(2) Penalty for Noncompliance. The purchasing governmental unit may impose a penalty in the amount of up to 15% of its payments to any provider that fails to submit required information. The purchasing governmental unit will notify the provider in advance of its intention to impose a penalty under .04(2).

322.05: Add-on and Supplemental Payment Provisions

(1) Providers Eligible for Add-on Payment. (a) To be eligible for Corrective Mobility System Repair add-on payments, as defined in 130 CMR 409.402, a provider must be 1. a MassHealth-enrolled DME provider; and 2. in compliance with the conditions of payment set forth in .05(1)(b). (b) Conditions of Payment. Add-on payments will be made only 1. for Corrective Mobility System Repairs. For purposes of .05, Maintenance Repairs, as defined in 130 CMR 409.402, are not Corrective Mobility System Repairs and would not qualify for an add-on payment; 2. under federally approved payment methods and consistent with federal funding requirements and all federal payment limits as determined by the Secretary of Health and Human Services; 3. to providers that meet service standards as defined by EOHHS via administrative bulletin or other written issuance, including standards related to timely service and turnaround times; 4. to providers that demonstrate compliance with other conditions of payment as described by EOHHS via administrative bulletin or other written issuance; and 5. to providers that comply with all applicable requirements of 130 CMR 409.000: Durable Medical Equipment Services. (c) Compliance with Conditions of Payment. 1. EOHHS may audit compliance with conditions of payment. 2. EOHHS may, via administrative bulletin or other written issuance, establish standards governing various conditions of payment including, but not limited to, attestations, reporting requirements, compliance with payment conditions, penalties for noncompliance, and recovery. (d) Timing of Payment. Add-on payments will be made at the same time as payment for the billable code is made pursuant to .06. (e) Corrective Mobility System Repair Add-on Payment Documentation. 1. MassHealth will pay DME providers an add-on payment of $1,000.00 per eligible mobility system repair when the mobility system repair is performed within the time period established by EOHHS via administrative bulletin or other written issuance to providers for qualifying mobility system repairs. 2. The mobility system must be thoroughly evaluated using a safety and performance evaluation or industry equivalent evaluation, and any qualifying repair must include any additional items that may not have been identified by the member at the time of the intake

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for the repair. The completed evaluation must be kept in the member’s file. 3. To receive an add-on payment, providers must comply with pre-payment and post- payment reporting requirements established by EOHHS, in addition to compliance with any administrative bulletin or other written issuance described in 101 CMR 322.05(1)(b)3. (f) Add-on Payment Reinvestment. Eighty percent (80%) of the add-on payment must be reinvested to improve the provider’s timeliness of mobility system repairs.

(2) Supplemental Payments for Services Provided to Dual Eligible Members. Supplemental payments apply to certain patient lift systems (HCPCS codes E0639 and E0640) or other designated services for MassHealth members who are eligible for both Medicare and MassHealth services (dual eligible members). (a) Provider eligibility. To be eligible to receive a supplemental payment for certain patient lift systems (HCPCS E0640 and E0639) or other designated services, a provider must be 1. a MassHealth-enrolled DME provider; and 2. in compliance with the conditions of payment set forth in .05(2)(b). (b) Conditions of Payment. Supplemental payments will be made only under federally approved payment methods and consistent with federal funding requirements and all federal payment limits as determined by the Secretary of Health and Human Services, for providers that 1. comply with other conditions of payment as described by EOHHS via administrative bulletin or other written issuance, including reconciliation of the total Medicare and total MassHealth payments; and 2. comply with all applicable requirements of 130 CMR 409.000: Durable Medical Equipment Services. (c) Compliance with Conditions of Payment. 1. EOHHS may audit compliance with conditions of payment. 2. EOHHS may, via administrative bulletin or other written issuance, establish standards governing various conditions of payment including, but not limited to, attestations, reporting requirements, compliance with payment conditions, penalties for noncompliance, and recovery. (d) Payment Methodology. The supplemental payment is calculated based on the MassHealth allowed amount (AAC+ the applicable markup defined in .02) minus the total Medicare allowed amount for the full rental period.

322.06: Allowable Fees and Rate Schedule: For code descriptions, see the DME service code spreadsheet at https://www.mass.gov/regulations/101-CMR-32200-rates-for-durable-medical-equipment-oxygen-and- respiratory-therapy-equipment-

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) 99601SD $86.99

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) 99602SD $45.48 A4206 $0.22 A4207 $0.43 A4208 $0.28 A4209 $0.45 A4210 AAC+ 20% A4210TW $4.98 A4211 AAC+ 20% A4212 $0.13 A4213 $0.76 A4215KX $0.23 A4215NU $0.10 A4216 $0.52 A4217AU $3.09 A4217NU $3.09 A4218 AAC+ 20% A4220 AAC+ 20% A4221 $20.79 A4222 $39.43 A4223 AAC+ 20% A4224 $20.79 A4225 $2.79 A4233NU $0.51 A4233NUKL $0.63 A4234NU $2.36 A4234NUKL $2.86 A4235NU $1.00 A4235NUKL $1.21 A4236NU $1.16 A4236NUKL $1.40 A4238KF $268.76 A4239 $261.64 A4239KF $304.43 A4244 $1.27 A4245 $3.61 A4246 $4.73

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4247 $3.56 A4248 AAC+ 20% A4250 $18.88 A4253NU $8.32 A4253NUKL $10.10 A4255 $5.34 A4256 $3.38 A4256KL $4.11 A4257 $17.41 A4258 $2.12 A4258KL $2.57 A4259 $1.42 A4259KL $1.73 A4264 AAC+ 20% A4265 $3.95 A4271 $65.25 A4281 $19.18 A4282 $28.35 A4283 $1.00 A4284 $18.45 A4285 $7.73 A4286 AAC+ 20% A4287 $0.20 A4305 AAC+ 20% A4306 AAC+ 20% A4310 $8.96 A4311 $16.20 A4312 $17.78 A4313 $18.26 A4314 $24.92 A4315 $26.00 A4316 $32.94 A4320 $6.20 A4321 AAC+ 20% A4322 $3.54 A4326 $12.03

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4327 $49.02 A4328 $10.29 A4330 $8.31 A4331 $3.69 A4332 $0.13 A4333 $2.58 A4334 $5.70 A4335 AAC+ 20% A4336 $1.67 A4337 AAC+ 20% A4338 $14.23 A4340 $36.82 A4341 $283.00 A4342 $714.56 A4344 $17.63 A4346 $22.71 A4349 $2.33 A4351 $2.10 A4352 $7.45 A4353 $8.11 A4354 $13.69 A4355 $8.79 A4356 $44.98 A4357 $9.57 A4358 $7.69 A4360 $0.48 A4361 $20.67 A4362 $3.43 A4363 $2.75 A4364 $3.35 A4366 $1.50 A4367 $7.68 A4368 $0.29 A4369 $2.81 A4371 $4.23 A4372 $4.87

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4373 $7.27 A4375 $19.92 A4376 $55.18 A4377 $4.97 A4378 $35.66 A4379 $17.42 A4380 $43.30 A4381 $5.36 A4382 $28.55 A4383 $32.69 A4384 $11.14 A4385 $5.91 A4387 $2.61 A4388 $5.06 A4389 $7.20 A4390 $11.14 A4391 $8.19 A4392 $9.48 A4393 $10.48 A4394 $3.01 A4395 $0.04 A4396 $46.95 A4398 $15.75 A4399 $14.23 A4400 $56.68 A4402 $1.57 A4404 $1.95 A4405 $3.96 A4406 $6.64 A4407 $10.16 A4408 $11.45 A4409 $7.20 A4410 $10.48 A4411 $5.91 A4412 $3.14 A4413 $6.39

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4414 $5.70 A4415 $6.95 A4416 $3.20 A4417 $4.33 A4418 $2.10 A4419 $2.00 A4420 AAC+ 20% A4421 AAC+ 20% A4422 $0.13 A4423 $2.15 A4424 $5.52 A4425 $4.15 A4426 $3.16 A4427 $3.24 A4428 $7.57 A4429 $9.57 A4430 $9.88 A4431 $7.20 A4432 $4.16 A4433 $3.89 A4434 $4.36 A4435 $6.68 A4436 $18.90 A4437 $18.90 A4450AU $0.09 A4450AV $0.09 A4450AW $0.12 A4452AU $0.41 A4452AV $0.41 A4452AW $0.44 A4453 AAC+ 20% A4455 $1.65 A4456 $0.28 A4457 AAC+ 30% A4458 AAC+ 20% A4459 AAC+ 20%

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4461 $3.83 A4463 $15.44 A4465 $11.52 A4467 AAC+ 20% A4468 AAC+ 20% A4470 AAC+ 20% A4480 AAC+ 20% A4481 $0.42 A4483 $69.60 A4490 $7.26 A4495 $28.85 A4500 $8.22 A4510 $11.61 A4520 AAC+ 20% A4540 AAC+ 30% A4541 $33.42 A4542 $428.75 A4543 AAC+ 20% A4544 $5.16 A4545 $31.37 A4550 $1.52 A4553 AAC+ 20% A4554 $0.29 A4555 AAC+ 20% A4556 $11.97 A4557 $10.53 A4558 $5.37 A4559 $0.11 A4560 AAC+ 20% A4561 $23.14 A4562 $57.62 A4565 $8.93 A4566 AAC+ 20% A4570 AAC+ 20% A4575 AAC+ 20% A4580 AAC+ 20%

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4590 AAC+ 20% A4593 AAC+ 30% A4594 AAC+ 30% A4595 $10.40 A4596 $33.42 A4600 AAC+ 20% A4601 AAC+ 20% A4602 $4.33 A4604NU $42.23 A4605NU $19.02 A4606 AAC+ 20% A4608 $58.14 A4611NU $175.33 A4611RR $18.18 A4611UE $131.50 A4612NU $71.34 A4612RR $7.27 A4612UE $54.40 A4613NU $109.40 A4613RR $10.95 A4613UE $79.12 A4614 $27.58 A4615 $0.85 A4616 $0.07 A4617 $3.60 A4618NU $10.32 A4618RR $1.20 A4618UE $7.74 A4619NU $2.07 A4620 $0.70 A4623 $7.61 A4623UA AAC+ 35% A4623UC AAC+ 35% A4624NU $2.60 A4625 $6.83 A4626 $3.70

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4627 $13.28 A4628NU $4.34 A4629 $5.40 A4630NU $7.23 A4633NU $47.60 A4634 AAC+ 20% A4635NU $5.92 A4635RR $0.81 A4635UE $3.95 A4636NU $3.19 A4636RR $0.32 A4636UE $2.39 A4637NU $1.77 A4637RR $0.18 A4637UE $1.33 A4638NU AAC+ 20% A4638RR IC A4638UE IC A4639KH $33.32 A4639KI $33.32 A4639KJ $24.99 A4639NU $333.20 A4639UE $249.90 A4640NU $58.23 A4640RR $5.82 A4640UE $43.67 A4649 AAC+ 20% A4651 AAC+ 20% A4652 AAC+ 20% A4653 AAC+ 20% A4657 AAC+ 20% A4660 $44.52 A4663 $30.08 A4670 $63.57 A4671 AAC+ 20% A4672 AAC+ 20%

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4673 AAC+ 20% A4674 AAC+ 20% A4680 AAC+ 20% A4690 AAC+ 20% A4706 AAC+ 20% A4707 AAC+ 20% A4708 AAC+ 20% A4709 AAC+ 20% A4714 AAC+ 20% A4719 AAC+ 20% A4720 AAC+ 20% A4721 AAC+ 20% A4722 AAC+ 20% A4723 AAC+ 20% A4724 AAC+ 20% A4725 AAC+ 20% A4726 AAC+ 20% A4728 AAC+ 20% A4730 AAC+ 20% A4736 AAC+ 20% A4737 AAC+ 20% A4740 AAC+ 20% A4750 AAC+ 20% A4755 AAC+ 20% A4760 AAC+ 20% A4765 AAC+ 20% A4766 AAC+ 20% A4770 AAC+ 20% A4771 AAC+ 20% A4773 AAC+ 20% A4774 AAC+ 20% A4802 AAC+ 20% A4860 AAC+ 20% A4870 AAC+ 20% A4890 AAC+ 20% A4911 AAC+ 20%

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A4913 AAC+ 20% A4918 AAC+ 20% A4927 $7.89 A4930 $0.36 A4931 AAC+ 20% A4932 AAC+ 20% A5051 $2.39 A5052 $1.73 A5053 $1.73 A5054 $2.08 A5055 $1.67 A5056 $5.42 A5057 $11.14 A5061 $4.10 A5062 $2.59 A5063 $3.14 A5071 $6.97 A5072 $4.10 A5073 $3.69 A5081 $3.84 A5082 $13.80 A5083 $0.75 A5093 $2.27 A5102 $25.98 A5105 $40.20 A5112 $34.72 A5113 $5.19 A5114 $8.82 A5120AU $0.28 A5120AV $0.31 A5121 $8.59 A5122 $12.66 A5126 $1.52 A5131 $18.39 A5200 $13.12 A6000 AAC+ 20%

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A6010 $35.92 A6011 $2.65 A6021 $24.39 A6022 $24.39 A6023 $220.72 A6024 $7.17 A6025 AAC+ 20% A6154 $16.68 A6196 $8.53 A6197 $19.07 A6198 AAC+ 20% A6199 $6.12 A6203 $3.91 A6204 $7.22 A6205 $14.64 A6206 AAC+ 20% A6207 $8.52 A6208 AAC+ 20% A6209 $8.67 A6210 $23.11 A6211 $34.07 A6212 $11.26 A6213 $9.25 A6214 $11.94 A6215 AAC+ 20% A6216 $0.04 A6217 $0.18 A6218 $0.57 A6219 $1.11 A6220 $3.01 A6221 AAC+ 20% A6222 $2.47 A6223 $2.81 A6224 $4.17 A6228 AAC+ 20% A6229 $4.17

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Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A6230 AAC+ 20% A6231 $5.42 A6232 $7.96 A6233 $22.24 A6234 $7.60 A6235 $19.51 A6236 $31.60 A6237 $9.17 A6238 $26.44 A6239 $20.53 A6240 $14.20 A6241 $2.98 A6242 $7.02 A6243 $14.30 A6244 $45.56 A6245 $8.43 A6246 $11.52 A6247 $27.58 A6248 $18.84 A6250 $9.21 A6251 $2.30 A6252 $3.77 A6253 $7.34 A6254 $1.39 A6255 $3.53 A6256 $1.38 A6257 $1.78 A6258 $5.00 A6259 $12.68 A6260 $11.23 A6261 AAC+ 20% A6262 $0.97 A6266 $2.22 A6402 $0.13 A6403 $0.48 A6404 $0.64

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A6407 $2.17 A6410 $0.43 A6411 AAC+ 20% A6412 AAC+ 20% A6413 AAC+ 20% A6441 $0.79 A6442 $0.19 A6443 $0.32 A6444 $0.65 A6445 $0.37 A6446 $0.45 A6447 $0.79 A6448 $1.33 A6449 $2.03 A6450 AAC+ 20% A6451 AAC+ 20% A6452 $6.84 A6453 $0.73 A6454 $0.91 A6455 $1.62 A6456 $1.45 A6457 $1.32 A6460 AAC+ 20% A6461 AAC+ 20% A6501 AAC+ 20% A6502 AAC+ 20% A6503 AAC+ 20% A6504 AAC+ 20% A6505 AAC+ 20% A6506 AAC+ 20% A6507 AAC+ 20% A6508 AAC+ 20% A6509 AAC+ 20% A6510 AAC+ 20% A6511 AAC+ 20% A6512 AAC+ 20%

30

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A6513 AAC+ 20% A6550 $25.45 A6590 $308.55 A6591 $73.76 A7000NU $8.11 A7001NU $36.30 A7002NU $4.22 A7003NU $1.51 A7004NU $1.25 A7005NU $11.48 A7006NU $7.29 A7007NU $3.22 A7008NU $12.75 A7009NU $46.14 A7010NU $15.05 A7012NU $2.81 A7013NU $0.54 A7014NU $3.27 A7015NU $1.24 A7016NU $7.94 A7017NU $113.87 A7017RR $11.39 A7017UE $85.40 A7018 $0.34 A7020 $16.17 A7021NU $116.27 A7023 AAC+ 20% A7025KH $50.45 A7025KI $50.45 A7025KJ $37.84 A7025NU $504.48 A7025UE $378.36 A7026NU $33.34 A7027NU $115.81 A7028NU $33.41 A7029NU $16.35

31

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A7030NU $94.93 A7031NU $35.01 A7032NU $19.90 A7033NU $16.12 A7034NU $56.55 A7035NU $19.63 A7036NU $11.09 A7037NU $12.42 A7038NU $2.29 A7039NU $6.16 A7040 $45.77 A7041 $86.05 A7042 $164.90 A7043 $26.13 A7044NU $83.16 A7045NU $13.41 A7045RR $1.34 A7045UE $10.06 A7046NU $13.39 A7047 $140.22 A7048 $56.36 A7049 AAC+ 20% A7501 $121.80 A7502 $57.90 A7503 $13.16 A7504 $0.79 A7505 $5.44 A7506 $0.37 A7507 $2.90 A7508 $3.33 A7509 $1.63 A7520NU $55.06 A7520UA AAC+ 35% A7520UC AAC+ 35% A7521NU $54.56 A7521UA AAC+ 35%

32

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A7521UC AAC+ 35% A7522NU $52.38 A7522UC AAC+ 35% A7523 AAC+ 20% A7524 $89.79 A7525 $2.39 A7526 $3.94 A7527 $4.15 A8000NU $177.87 A8000RR $17.79 A8000UE $133.43 A8001NU $177.87 A8001RR $17.79 A8001UE $133.43 A8002NU AAC+ 30% A8002RR IC A8002UE IC A8003NU AAC+ 30% A8003RR IC A8003UE IC A8004NU AAC+ 30% A8004RR IC A8004UE IC A9156 AAC+ 30% A9268 AAC+ 30% A9269 AAC+ 30% A9272 AAC+ 20% A9273 AAC+ 20% A9274 AAC+ 30% A9275 AAC+ 30% A9276 AAC+ 30% A9277 AAC+ 30% A9278 AAC+ 30% A9279 AAC+ 30% A9280 AAC+ 30% A9281 AAC+ 20%

33

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) A9282 AAC+ 20% A9284 AAC+ 20% A9286 AAC+ 20% A9300 AAC+ 30% A9900 AAC+ 20% A9901 $3.00 A9999 AAC+ 20% B4034 $3.16 B4035 $5.06 B4036 $4.34 B4081 $16.24 B4082 $11.29 B4083 $1.65 B4087NU $29.56 B4087UC $144.00 B4088NU $35.39 B4088UC $144.00 B4100 AAC+ 25% B4100BO AAC+ 25% B4102 AAC+ 25% B4102BA AAC+ 25% B4102BO AAC+ 25% B4103 AAC+ 25% B4103BA AAC+ 25% B4103BO AAC+ 25% B4104 AAC+ 25% B4104BA AAC+ 25% B4104BO AAC+ 25% B4105 AAC+ 20% B4148 AAC+ 25% B4149BA AAC+ 35% B4149BO AAC+ 35% B4150BA $0.38 B4150BO $2.00 B4152BA $0.32 B4152BO $1.84

34

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) B4153BA $1.16 B4153BO $11.26 B4154BA $0.65 B4154BO AAC+ 35% B4155BA $0.77 B4155BO AAC+ 35% B4157BA AAC+ 35% B4157BO AAC+ 35% B4158BA AAC+ 35% B4158BO AAC+ 35% B4159BA AAC+ 35% B4159BO AAC+ 35% B4160BA AAC+ 35% B4160BO AAC+ 35% B4161BA AAC+ 35% B4161BO AAC+ 35% B4162BA AAC+ 35% B4162BO AAC+ 35% B4164 $20.47 B4168 $29.85 B4172 AAC+ 25% B4176 $57.75 B4178 $69.30 B4180 $29.38 B4185BA $10.97 B4187 $13.52 B4189 $214.08 B4193 $276.62 B4197 $336.78 B4199 $384.82 B4216 $9.30 B4220 $9.64 B4222 $11.89 B4224 $30.11 B5000 $14.32 B5100 $5.59

35

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) B5200 AAC+ 25% B9002MS $30.82 B9002NU $616.42 B9002RR $61.64 B9002UE $462.32 B9004MS $240.52 B9004NU $3,038.76 B9004RR $481.04 B9004UE $2,279.06 B9006NU $3,038.76 B9006RR $481.04 B9006UE $2,279.06 B9998 AAC+ 20% B9999 AAC+ 20% E0100NU $23.53 E0100RR $6.18 E0100UE $17.63 E0105NU $56.18 E0105RR $8.75 E0105UD AAC+ 30% E0105UE $42.17 E0110NU $89.99 E0110RR $18.54 E0110UD AAC+ 30% E0110UE $67.46 E0111NU $61.75 E0111RR $9.78 E0111UD AAC+ 30% E0111UE $47.68 E0112NU $36.49 E0112RR $9.80 E0112UD AAC+ 30% E0112UE $27.83 E0113NU $24.52 E0113RR $5.96 E0113UD AAC+ 30%

36

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0113UE $18.39 E0114NU $46.52 E0114RR $8.45 E0114UD AAC+ 30% E0114UE $35.17 E0116NU $32.18 E0116RR $5.34 E0116UD AAC+ 30% E0116UE $24.23 E0117KH $22.34 E0117KI $22.34 E0117KJ $16.75 E0117NU $223.38 E0117UD AAC+ 30% E0117UE $167.54 E0118NU AAC+ 30% E0118RR IC E0118UE IC E0130NU $44.23 E0130RR $4.42 E0130UD AAC+ 30% E0130UE $33.18 E0135NU $44.23 E0135RR $4.42 E0135UD AAC+ 30% E0135UE $33.18 E0140KH $27.38 E0140KI $27.38 E0140KJ $20.53 E0140NU $273.79 E0140UC AAC+ 30% E0140UD AAC+ 30% E0140UE $205.34 E0141NU $44.64 E0141RR $4.46 E0141UC AAC+ 30%

37

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0141UD AAC+ 30% E0141UE $33.48 E0143NU $44.64 E0143RR $4.46 E0143UC AAC+ 30% E0143UD AAC+ 30% E0143UE $33.48 E0144KH $27.61 E0144KI $27.61 E0144KJ $20.71 E0144NU $276.08 E0144UC AAC+ 30% E0144UD AAC+ 30% E0144UE $207.06 E0147NU $412.37 E0147RR $41.24 E0147UD AAC+ 30% E0147UE $309.28 E0148NU $80.60 E0148RR $8.06 E0148UD AAC+ 30% E0148UE $60.45 E0149KH $9.89 E0149KI $9.89 E0149KJ $7.41 E0149NU $98.86 E0149UD AAC+ 30% E0149UE $74.14 E0152 AAC+ 30% E0153NU $68.42 E0153RR $7.74 E0153UC AAC+ 30% E0153UD AAC+ 30% E0153UE $51.30 E0154NU $50.50 E0154RR $5.05

38

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0154UC AAC+ 30% E0154UD AAC+ 30% E0154UE $37.88 E0155NU $21.34 E0155RR $2.13 E0155UD AAC+ 30% E0155UE $16.01 E0156NU $15.65 E0156RR $1.56 E0156UD AAC+ 30% E0156UE $11.74 E0157NU $54.89 E0157RR $5.49 E0157UE $41.17 E0158NU $22.27 E0158RR $2.23 E0158UD AAC+ 30% E0158UE $16.70 E0159NU $14.48 E0159RR $1.45 E0159UD AAC+ 30% E0159UE $10.86 E0160NU $30.58 E0160RR $3.06 E0160UE $22.94 E0161NU $24.42 E0161RR $2.44 E0161UE $18.32 E0162NU $168.99 E0162RR $17.74 E0162UE $131.04 E0163NU $48.33 E0163RR $4.84 E0163UD AAC+ 30% E0163UE $36.25 E0165KH $11.58

39

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0165KI $11.58 E0165KJ $8.68 E0165NU $115.77 E0165UD AAC+ 30% E0165UE $86.83 E0167NU $11.89 E0167RR $1.19 E0167UD AAC+ 30% E0167UE $8.93 E0168NU $117.62 E0168RR $11.76 E0168UE $88.21 E0170KH $166.40 E0170KI $166.40 E0170KJ $124.80 E0170NU $1,664.05 E0170UD AAC+ 30% E0170UE $1,248.03 E0171KH $31.37 E0171KI $31.37 E0171KJ $23.53 E0171NU $313.74 E0171UD AAC+ 30% E0171UE $235.30 E0172 AAC+ 30% E0175NU $75.37 E0175RR $7.57 E0175UE $56.54 E0181KH $14.48 E0181KI $14.48 E0181KJ $10.86 E0181NU $144.76 E0181UE $108.57 E0182KH $20.49 E0182KI $20.49 E0182KJ $15.37

40

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0182NU $204.94 E0182UE $153.70 E0183KH $14.48 E0183KI $14.48 E0183KJ $10.86 E0184NU $160.99 E0184RR $16.10 E0184UE $120.74 E0185NU $164.36 E0185RR $16.44 E0185UE $123.28 E0186KH $19.33 E0186KI $19.33 E0186KJ $14.50 E0186NU $193.29 E0186UE $144.97 E0187KH $22.03 E0187KI $22.03 E0187KJ $16.52 E0187NU $220.32 E0187UE $165.24 E0188NU $23.69 E0188RR $2.37 E0188UE $17.77 E0189NU $50.92 E0189RR $5.09 E0189UE $38.19 E0190NU AAC+ 30% E0190RR IC E0190UE IC E0191NU $11.59 E0191RR $1.20 E0191UE $8.64 E0193KH $676.83 E0193KI $676.83 E0193KJ $507.62

41

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0194KH $3,774.31 E0194KI $3,774.31 E0194KJ $2,830.73 E0196KH $32.03 E0196KI $32.03 E0196KJ $24.02 E0196NU $320.28 E0196UE $240.21 E0197KH $18.96 E0197KI $18.96 E0197KJ $14.22 E0197NU $189.55 E0197UE $142.16 E0198KH $21.85 E0198KI $21.85 E0198KJ $16.38 E0198NU $218.45 E0198UE $163.84 E0199NU $31.29 E0199RR $3.13 E0199UE $23.47 E0200NU $78.15 E0200RR $10.62 E0200UE $58.65 E0201NU $122.10 E0201RR $12.21 E0201UE $91.58 E0202RR $125.00 E0203 AAC+ 30% E0205NU $191.31 E0205RR $21.05 E0205UE $143.48 E0210NU $37.88 E0210RR $3.09 E0210UE $28.38 E0215NU $69.84

42

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0215RR $7.31 E0215UE $52.39 E0217NU $575.79 E0217RR $64.10 E0217UE $431.82 E0218 AAC+ 30% E0221 $1,690.77 E0225NU $383.14 E0225RR $37.77 E0225UE $287.35 E0231 AAC+ 30% E0232 AAC+ 30% E0235KH $18.29 E0235KI $18.29 E0235KJ $13.72 E0235NU $182.92 E0235UE $137.19 E0236KH $51.31 E0236KI $51.31 E0236KJ $38.49 E0236NU $513.15 E0236UE $384.86 E0239NU $521.70 E0239RR $52.18 E0239UE $391.29 E0240NU AAC+ 30% E0240RR IC E0240UE IC E0241 $32.36 E0242 $69.79 E0243 $38.14 E0244 $60.76 E0244UD AAC+ 30% E0245 $42.37 E0245UD AAC+ 30% E0246 $99.65

43

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0247NU AAC+ 30% E0247RR IC E0247UE IC E0248NU AAC+ 30% E0248RR IC E0248UE IC E0249NU $115.52 E0249RR $12.69 E0249UE $86.62 E0250KH $58.50 E0250KI $58.50 E0250KJ $43.87 E0250NU $584.97 E0250RB AAC+ 30% E0250UE $438.73 E0251KH $56.19 E0251KI $56.19 E0251KJ $42.15 E0251NU $561.94 E0251RB AAC+ 30% E0251UE $421.45 E0255KH $58.50 E0255KI $58.50 E0255KJ $43.87 E0255NU $584.97 E0255RB AAC+ 30% E0255UE $438.73 E0256KH $58.50 E0256KI $58.50 E0256KJ $43.87 E0256NU $584.97 E0256RB AAC+ 30% E0256UE $438.73 E0260KH $58.50 E0260KI $58.50 E0260KJ $43.87

44

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0260NU $584.97 E0260RB AAC+ 30% E0260UE $438.73 E0261KH $58.50 E0261KI $58.50 E0261KJ $43.87 E0261NU $584.97 E0261RB AAC+ 30% E0261UE $438.73 E0265KH $147.86 E0265KI $147.86 E0265KJ $110.89 E0265NU $1,478.58 E0265RB AAC+ 30% E0265UE $1,108.93 E0266KH $128.66 E0266KI $128.66 E0266KJ $96.49 E0266NU $1,286.56 E0266RB AAC+ 30% E0266UE $964.92 E0270 AAC+ 30% E0271NU $114.91 E0271RR $11.49 E0271UE $86.18 E0272NU $143.84 E0272RR $14.38 E0272UE $107.87 E0273 $44.73 E0274NU $60.99 E0274RR $6.10 E0274UE $45.74 E0275NU $15.00 E0275RR $1.50 E0275UE $11.25 E0276NU $12.23

45

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0276RR $1.22 E0276UE $9.17 E0277KH $188.45 E0277KI $188.45 E0277KJ $141.34 E0277NU $1,884.54 E0277UE $1,413.40 E0280NU $30.97 E0280RR $3.09 E0280UE $23.23 E0290KH $57.10 E0290KI $57.10 E0290KJ $42.83 E0290NU $571.03 E0290RB AAC+ 30% E0290UE $428.27 E0291KH $47.49 E0291KI $47.49 E0291KJ $35.62 E0291NU $474.90 E0291RB AAC+ 30% E0291UE $356.17 E0292KH $58.50 E0292KI $58.50 E0292KJ $43.87 E0292NU $584.97 E0292RB AAC+ 30% E0292UE $438.73 E0293 AAC+ 30% E0293KH $56.85 E0293KI $56.85 E0293KJ $42.64 E0293NU $568.48 E0293UE $426.36 E0294KH $58.50 E0294KI $58.50

46

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0294KJ $43.87 E0294NU $584.97 E0294RB AAC+ 30% E0294UE $438.73 E0295KH $58.50 E0295KI $58.50 E0295KJ $43.87 E0295NU $584.97 E0295RB AAC+ 30% E0295UE $438.73 E0296KH $115.36 E0296KI $115.36 E0296KJ $86.52 E0296NU $1,153.62 E0296RB AAC+ 30% E0296UE $865.22 E0297KH $101.80 E0297KI $101.80 E0297KJ $76.35 E0297NU $1,018.05 E0297RB AAC+ 30% E0297UE $763.53 E0300KH $257.07 E0300KI $257.07 E0300KJ $192.80 E0300NU AAC+ 30% E0300RB AAC+ 30% E0300UE IC E0301KH $150.95 E0301KI $150.95 E0301KJ $113.21 E0301NU $1,509.52 E0301RB AAC+ 30% E0301UE $1,132.14 E0302KH $470.76 E0302KI $470.76

47

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0302KJ $353.07 E0302NU $4,707.56 E0302RB AAC+ 30% E0302UE $3,530.67 E0303KH $152.87 E0303KI $152.87 E0303KJ $114.65 E0303NU $1,528.73 E0303RB AAC+ 30% E0303UE $1,146.54 E0304KH $478.38 E0304KI $478.38 E0304KJ $358.79 E0304NU $4,783.80 E0304RB AAC+ 30% E0304UE $3,587.85 E0305KH $10.88 E0305KI $10.88 E0305KJ $8.16 E0305NU $108.80 E0305UE $81.60 E0310NU $114.22 E0310RR $11.42 E0310UE $85.67 E0315NU $74.32 E0315RR $7.43 E0315UE $55.74 E0316KH $210.93 E0316KI $210.93 E0316KJ $158.20 E0316NU $2,109.28 E0316UE $1,581.96 E0325NU $9.66 E0325RR $0.97 E0325UE $7.24 E0326NU $10.39

48

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0326RR $1.04 E0326UE $7.79 E0328 AAC+ 30% E0328UA AAC+ 30% E0329 AAC+ 30% E0329UA AAC+ 30% E0350 AAC+ 30% E0352 AAC+ 20% E0370 AAC+ 20% E0371KH $188.45 E0371KI $188.45 E0371KJ $141.34 E0371NU $1,884.54 E0371UE $1,413.40 E0372KH $188.45 E0372KI $188.45 E0372KJ $141.34 E0372NU $1,884.54 E0372UE $1,413.40 E0373KH $188.45 E0373KI $188.45 E0373KJ $141.34 E0373NU $1,884.54 E0373UE $1,413.40 E0424RR $79.98 E0425 AAC+ 30% E0430 AAC+ 30% E0431RR $17.76 E0433RR $40.83 E0434RR $40.83 E0435 AAC+ 30% E0439QF $79.98 E0439QG $79.98 E0439RR $79.98 E0440 AAC+ 30% E0441 $53.17

49

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0442 $53.17 E0443RR $49.16 E0444RR $49.16 E0445NU $856.30 E0445RR $85.63 E0445UE $642.23 E0446 AAC+ 30% E0447 $73.75 E0455 AAC+ 20% E0457NU $548.45 E0457RR $54.84 E0457UE $411.31 E0459KH $45.42 E0459KI $45.42 E0459KJ $34.06 E0459NU $476.86 E0459UE $357.65 E0462KH $287.28 E0462KI $287.28 E0462KJ $215.46 E0462NU $2,872.83 E0462UE $2,154.62 E0465RR $1,107.04 E0465U2 $1,302.40 E0466RR $1,107.04 E0466U2 $1,302.40 E0467RR $1,293.44 E0467U2 $1,521.69 E0468RR $1,190.16 E0468U2 $1,400.19 E0469KH $1,500.68 E0469KI $1,500.68 E0469KJ $1,125.51 E0469NU $15,006.80 E0469UE $11,255.10 E0470KH $108.88

50

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0470KI $108.88 E0470KJ $81.66 E0470NU $1,088.77 E0470UE $816.57 E0471KH $270.53 E0471KI $270.53 E0471KJ $202.90 E0471NU $2,705.30 E0471UE $2,028.97 E0472KH $388.38 E0472KI $388.38 E0472KJ $291.29 E0472NU $3,883.82 E0472UE $2,912.87 E0480KH $50.97 E0480KI $50.97 E0480KJ $38.23 E0480NU $509.75 E0480UE $382.31 E0481 AAC+ 30% E0482KH $498.75 E0482KI $498.75 E0482KJ $374.06 E0482NU $4,987.46 E0482UE $3,740.60 E0483KH $1,233.01 E0483KI $1,233.01 E0483KJ $924.76 E0483NU $12,330.10 E0483UE $9,247.58 E0484NU $42.84 E0484RR $4.28 E0484UE $32.13 E0485NU AAC+ 30% E0485RR IC E0485UE IC

51

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0486NU $1,881.22 E0487 AAC+ 30% E0490KH $103.83 E0490KI $103.83 E0490KJ $77.87 E0490NU $1,221.50 E0490RR $122.15 E0490UE $916.13 E0491 $85.75 E0492 AAC+ 30% E0493 AAC+ 30% E0500RR $127.30 E0530KH $35.54 E0530KI $35.54 E0530KJ $22.66 E0530NU $355.40 E0530UE $266.55 E0550KH $49.43 E0550KI $49.43 E0550KJ $37.07 E0550NU $494.28 E0550UE $370.71 E0555 AAC+ 30% E0560NU $171.44 E0560RR $20.09 E0560UE $128.59 E0561NU $74.34 E0561RR $7.44 E0561UE $55.76 E0562NU $141.81 E0562RR $14.18 E0562UE $106.35 E0565KH $43.54 E0565KI $43.54 E0565KJ $32.65 E0565NU $435.37

52

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0565UE $326.53 E0570KH $6.01 E0570KI $6.01 E0570KJ $4.51 E0570NU $60.10 E0570UE $45.07 E0572KH $27.01 E0572KI $27.01 E0572KJ $20.26 E0572NU $270.13 E0572UE $202.60 E0574KH $46.68 E0574KI $46.68 E0574KJ $35.01 E0574NU $466.82 E0574UE $350.12 E0575KH $119.20 E0575KI $119.20 E0575KJ $89.40 E0575NU $1,192.04 E0575UE $894.03 E0580NU $133.99 E0580RR $13.40 E0580UE $100.48 E0585KH $28.44 E0585KI $28.44 E0585KJ $21.33 E0585NU $284.41 E0585UE $213.31 E0600KH $53.10 E0600KI $53.10 E0600KJ $39.82 E0600NU $531.00 E0600UE $398.25 E0601KH $40.89 E0601KI $40.89

53

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0601KJ $30.66 E0601NU $408.85 E0601UE $306.64 E0602NU $34.23 E0602RR $3.45 E0602UE $25.68 E0603NU $213.20 E0604RR $70.00 E0605NU $36.04 E0605RR $3.63 E0605UE $27.08 E0606KH $26.61 E0606KI $26.61 E0606KJ $19.96 E0606NU $266.14 E0606UE $199.60 E0607NU $77.49 E0607RR $7.74 E0607UE $58.11 E0610NU $234.47 E0610RR $24.74 E0610UE $175.88 E0615NU $555.29 E0615RR $67.85 E0615UE $416.52 E0616 AAC+ 30% E0617KH $352.61 E0617KHKF $352.61 E0617KI $352.61 E0617KIKF $352.61 E0617KJ $264.46 E0617KJKF $264.46 E0617NU $3,526.14 E0617NUKF $3,526.14 E0617UE $2,644.61 E0617UEKF $2,644.61

54

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0618KH $325.16 E0618KI $325.16 E0618KJ $243.87 E0619KH $224.28 E0619KI $224.28 E0619KJ $168.21 E0620KH $101.40 E0620KI $101.40 E0620KJ $76.05 E0620NU $1,013.97 E0620UE $760.47 E0621NU $91.84 E0621RR $9.19 E0621UE $68.88 E0625NU AAC+ 30% E0625RR IC E0625UE IC E0627NU $251.71 E0627RR $25.17 E0627UE $188.78 E0629NU $251.37 E0629RR $25.13 E0629UE $188.53 E0630KH $58.22 E0630KI $58.22 E0630KJ $43.66 E0630NU $582.17 E0630RB AAC+ 30% E0630UE $436.62 E0635KH $117.68 E0635KI $117.68 E0635KJ $88.26 E0635NU $1,176.83 E0635RB AAC+ 30% E0635U1 AAC+ 35% E0635UE $882.62

55

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0636KH $966.11 E0636KI $966.11 E0636KJ $724.58 E0636NU $9,661.10 E0636RB AAC+ 30% E0636UE $7,245.83 E0637NU $2,104.97 E0637RR $210.51 E0637UE $1,578.72 E0638NU $853.57 E0638RR $85.36 E0638UC AAC+ 35% E0638UD AAC+ 35% E0638UE $640.18 E0639KH $129.38 E0639KI $129.38 E0639KJ $97.03 E0639NU AAC+ 35% E0639RB AAC+ 35% E0639UE $970.34 E0640KH $129.38 E0640KI $129.38 E0640KJ $97.03 E0640NU AAC+ 35% E0640RB AAC+ 35% E0640UE $970.34 E0641 AAC+ 30% E0642 AAC+ 30% E0650NU $835.28 E0650RR $103.08 E0650UE $626.47 E0651NU $905.38 E0651RR $107.25 E0651UE $679.06 E0652NU $6,148.53 E0652RR $516.51

56

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0652UE $4,607.27 E0655NU $118.01 E0655RR $12.50 E0655UE $88.50 E0656KH $67.02 E0656KI $67.02 E0656KJ $50.27 E0656NU $670.23 E0656UE $502.67 E0657KH $62.96 E0657KI $62.96 E0657KJ $47.22 E0657NU $629.60 E0657UE $472.20 E0660NU $183.52 E0660RR $16.39 E0660UE $137.65 E0665NU $158.89 E0665RR $15.33 E0665UE $119.31 E0666NU $160.16 E0666RR $16.49 E0666UE $120.14 E0667NU $319.18 E0667RR $42.40 E0667UE $239.39 E0668NU $512.48 E0668RR $50.58 E0668UE $384.38 E0669NU $201.88 E0669RR $20.18 E0669UE $151.41 E0670NU $1,239.22 E0670RR $156.06 E0670UE $929.36 E0671NU $481.72

57

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0671RR $48.20 E0671UE $361.26 E0672NU $374.28 E0672RR $37.46 E0672UE $280.73 E0673NU $311.01 E0673RR $31.10 E0673UE $233.30 E0675KH $445.99 E0675KI $445.99 E0675KJ $334.49 E0675NU $4,459.87 E0675UE $3,344.90 E0676 AAC+ 30% E0677KHKI $67.02 E0677KJ $59.14 E0677NU $788.50 E0677UE $591.38 E0678KH $37.55 E0678KI $37.55 E0678KJ $28.16 E0678NU $375.50 E0678UE $281.63 E0679KH $23.75 E0679KI $23.75 E0679KJ $17.81 E0679NU $237.50 E0679UE $178.13 E0680KH $723.36 E0680KI $723.36 E0680KJ $542.52 E0680NU $7,233.60 E0680UE $5,425.20 E0681KH $106.52 E0681KI $106.52 E0681KJ $79.89

58

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0681NU $1,065.20 E0681UE $798.90 E0682KH $60.29 E0682KI $60.29 E0682KJ $45.22 E0682NU $602.90 E0682UE $452.18 E0683KH $78.06 E0683KI $78.06 E0683KJ $58.55 E0683NU $780.60 E0683UE $585.45 E0691NU $1,042.16 E0691RR $104.21 E0691UE $781.63 E0692NU $1,308.68 E0692RR $130.85 E0692UE $981.50 E0693NU $1,613.22 E0693RR $161.33 E0693UE $1,209.92 E0694NU $5,134.75 E0694RR $513.47 E0694UE $3,851.09 E0700 AAC+ 30% E0705NU $44.12 E0705NUKU $74.88 E0705RR $4.41 E0705RRKU $7.65 E0705UE $33.08 E0705UEKU $55.08 E0710 AAC+ 20% E0711 AAC+ 20% E0715 AAC + 30% E0716 AAC + 20% E0720NU $66.34

59

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0721 AAC+ 30% E0730NU $66.01 E0731NU $79.60 E0732KH $50.15 E0732KI $50.15 E0732KJ $37.61 E0732NU $501.50 E0732UE $376.13 E0733KH $50.15 E0733KI $50.15 E0733KJ $37.61 E0733NU $501.50 E0733UE $376.13 E0734KH $429.24 E0734KI $429.24 E0734KJ $321.93 E0734NU $4,292.40 E0734UE $3,219.30 E0735KH $50.15 E0735KI $50.15 E0735KJ $37.61 E0735NU $501.50 E0735UE $376.13 E0736 AAC+ 30% E0737 AAC+ 30% E0738 AAC+ 30% E0739 AAC+ 30% E0740KH $60.65 E0740KI $60.65 E0740KJ $45.49 E0740NU $606.48 E0740UE $454.86 E0743KH $231.88 E0743KI $231.88 E0743KJ $173.91 E0743NU $2,318.80

60

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0743UE $1,739.10 E0744KH $106.21 E0744KI $106.21 E0744KJ $79.66 E0744NU $1,062.08 E0744UE $796.56 E0745KH $103.83 E0745KI $103.83 E0745KJ $77.87 E0745NU $1,038.28 E0745UE $778.71 E0746 AAC+ 30% E0747NUKF $3,860.51 E0747RRKF $383.62 E0747UEKF $2,868.29 E0748NUKF $4,512.37 E0748RRKF $451.21 E0748UEKF $3,384.28 E0749KHKF $329.80 E0749KIKF $329.80 E0749KJKF $247.35 E0749NUKF $3,298.00 E0749UEKF $2,473.50 E0755 AAC+ 30% E0760NUKF $3,749.69 E0760RRKF $374.97 E0760UEKF $2,812.23 E0761 AAC+ 30% E0762KH $108.40 E0762KI $108.40 E0762KJ $81.30 E0762NU $1,084.01 E0762UE $813.00 E0764KHKF $1,283.48 E0764KIKF $1,283.48 E0764KJKF $962.61

61

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0764NUKF $12,834.83 E0764UEKF $9,626.12 E0765NU $97.57 E0765RR $9.78 E0765UE $73.20 E0766RRKF $13,333.92 E0767 AAC+ 30% E0769 AAC+ 30% E0770NU AAC+ 30% E0776NU $147.63 E0776NUBA $52.51 E0776RR $14.76 E0776RRBA $5.25 E0776UE $110.72 E0776UEBA $39.39 E0779KH $19.15 E0779KI $19.15 E0779KJ $14.36 E0779NU $191.51 E0779UE $143.63 E0780NU $12.03 E0781KH $248.56 E0781KI $248.56 E0781KJ $186.42 E0781NU $2,485.57 E0781UE $1,864.18 E0782NUKF $4,232.52 E0782RRKF $423.27 E0782UEKF $3,174.38 E0783NUKF $9,495.00 E0783RRKF $949.52 E0783UEKF $7,121.28 E0784KH $448.18 E0784KI $448.18 E0784KJ $336.13 E0784NU AAC+ 30%

62

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0784UE $3,361.35 E0785KF $548.01 E0786NUKF $8,927.54 E0786RRKF $892.76 E0786UEKF $6,695.67 E0787 IC E0791KH $295.28 E0791KI $295.28 E0791KJ $221.46 E0791NU $2,952.82 E0791UE $2,214.61 E0830NU AAC+ 30% E0840NU $84.97 E0840RR $16.86 E0840UE $63.71 E0849KH $59.77 E0849KI $59.77 E0849KJ $44.83 E0849NU $597.72 E0849UE $448.29 E0850NU $121.83 E0850RR $14.23 E0850UE $91.38 E0855KH $58.29 E0855KI $58.29 E0855KJ $43.72 E0855NU $582.93 E0855UE $437.20 E0856KH $17.85 E0856KI $17.85 E0856KJ $13.39 E0856NU $178.50 E0856UE $133.88 E0860NU $44.69 E0860RR $7.57 E0860UE $34.22

63

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0870NU $134.90 E0870RR $15.56 E0870UE $101.63 E0880NU $145.60 E0880RR $22.86 E0880UE $110.20 E0890NU $139.64 E0890RR $38.08 E0890UE $112.49 E0900NU $148.61 E0900RR $32.05 E0900UE $111.49 E0910KH $10.85 E0910KI $10.85 E0910KJ $8.14 E0910NU $108.55 E0910UE $81.41 E0911KH $42.52 E0911KI $42.52 E0911KJ $31.89 E0911NU $425.17 E0911UE $318.88 E0912KH $77.21 E0912KI $77.21 E0912KJ $57.90 E0912NU $772.06 E0912UE $579.04 E0920KH $53.53 E0920KI $53.53 E0920KJ $40.15 E0920NU $535.33 E0920UE $401.50 E0930KH $52.97 E0930KI $52.97 E0930KJ $39.73 E0930NU $529.72

64

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0930UE $397.29 E0935RR $26.38 E0936 AAC+ 30% E0940KH $21.82 E0940KI $21.82 E0940KJ $16.36 E0940NU $218.20 E0940UE $163.65 E0941KH $42.79 E0941KI $42.79 E0941KJ $32.09 E0941NU $427.89 E0941UE $320.92 E0942NU $23.02 E0942RR $2.32 E0942UE $17.22 E0944NU $53.20 E0944RR $4.61 E0944UE $39.90 E0945NU $51.40 E0945RR $4.36 E0945UE $39.80 E0946KH $68.62 E0946KI $68.62 E0946KJ $51.47 E0946NU $686.21 E0946UE $514.65 E0947NU $703.36 E0947RR $72.92 E0947UE $527.50 E0948NU $680.30 E0948RR $68.01 E0948UE $479.83 E0950NU $83.92 E0950NUKU $103.92 E0950RR $8.39

65

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0950RRKU $10.41 E0950U1 AAC+ 35% E0950UE $62.94 E0950UEKU $77.94 E0951NU $14.22 E0951NUKU $20.07 E0951RR $1.42 E0951RRKU $2.29 E0951UE $10.66 E0951UEKU $15.07 E0952NU $19.61 E0952NUKU $19.87 E0952RR $1.96 E0952RRKU $2.29 E0952UE $14.71 E0952UEKU $14.88 E0953NU $73.29 E0953NUKU $115.92 E0953RR $7.33 E0953RRKU $11.58 E0953UE $54.96 E0953UEKU $86.94 E0954NU $52.45 E0954NUKU $68.49 E0954RR $5.24 E0954RRKU $7.42 E0954UE $39.34 E0954UEKU $51.34 E0955KH $14.52 E0955KHKU $14.52 E0955KI $14.52 E0955KIKU $14.52 E0955KJ $10.89 E0955KJKU $10.89 E0955NU $145.18 E0955NUKU $145.18

66

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0955UE $108.89 E0955UEKU $108.89 E0956NU $86.22 E0956NUKU $115.92 E0956RR $8.62 E0956RRKU $11.58 E0956UE $64.66 E0956UEKU $86.94 E0957NU $139.14 E0957NUKU $162.23 E0957RR $13.91 E0957RRKU $16.24 E0957UE $104.36 E0957UEKU $121.65 E0958KH $39.57 E0958KHKU $39.57 E0958KI $39.57 E0958KIKU $39.57 E0958KJ $29.68 E0958KJKU $29.68 E0958NU $395.68 E0958NUKU $395.68 E0958UE $296.76 E0958UEKU $296.76 E0959NU $53.20 E0959NUKU $60.30 E0959RR $5.32 E0959RRKU $5.34 E0959UE $39.90 E0959UEKU $45.66 E0960NU $76.36 E0960NUKU $107.00 E0960RR $7.64 E0960RRKU $10.73 E0960UE $57.27 E0960UEKU $80.26

67

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0961NU $24.78 E0961NUKU $40.60 E0961RR $2.48 E0961RRKU $3.60 E0961UE $17.22 E0961UEKU $17.20 E0966NU $80.99 E0966NUKU $97.39 E0966RR $8.10 E0966RRKU $9.03 E0966UE $60.75 E0966UEKU $73.03 E0967NU $86.04 E0967NUKU $89.61 E0967RR $8.60 E0967RRKU $8.98 E0967UE $64.53 E0967UEKU $67.17 E0968KH $19.66 E0968KI $19.66 E0968KJ $14.75 E0968NU $196.61 E0968UE $147.45 E0969NU $213.71 E0969RR $18.03 E0969UE $160.29 E0971NU $34.90 E0971NUKU $59.20 E0971RR $3.49 E0971RRKU $5.93 E0971UE $26.17 E0971UEKU $44.44 E0973NU $58.19 E0973NUKU $135.22 E0973RR $5.82 E0973RRKU $10.94

68

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0973UE $43.64 E0973UEKU $101.40 E0974NU $82.30 E0974NUKU $101.05 E0974RR $8.23 E0974RRKU $9.64 E0974UD AAC+ 35% E0974UE $61.72 E0974UEKU $75.79 E0978NU $28.06 E0978NUKU $50.21 E0978RR $2.80 E0978RRKU $5.04 E0978UE $21.05 E0978UEKU $37.22 E0980NU $45.10 E0980RR $4.52 E0980UE $33.63 E0981NU $49.13 E0981NUKU $55.43 E0981RR $4.79 E0981RRKU $4.79 E0981UC AAC+ 35% E0981UE $36.85 E0981UEKU $41.97 E0982NU $54.40 E0982NUKU $60.59 E0982RR $5.15 E0982RRKU $5.13 E0982UE $40.80 E0982UEKU $45.47 E0983KH $289.87 E0983KI $289.87 E0983KJ $217.40 E0983NU $2,898.67 E0983UE $2,174.00

69

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0984KH $204.22 E0984KI $204.22 E0984KJ $153.17 E0984NU $2,042.21 E0984UE $1,531.66 E0985KH $21.54 E0985KHKU $21.54 E0985KI $21.54 E0985KIKU $21.54 E0985KJ $16.15 E0985KJKU $16.15 E0985NU $215.39 E0985NUKU $215.39 E0985UE $161.54 E0985UEKU $161.54 E0986KH $564.16 E0986KI $564.16 E0986KJ $423.12 E0986NU $5,641.62 E0986UE $4,231.22 E0988KH $333.82 E0988KI $333.82 E0988KJ $250.37 E0988NU $3,338.21 E0988UE $2,503.65 E0990NU $75.02 E0990NUKU $138.10 E0990RR $7.50 E0990RRKU $15.56 E0990UE $56.26 E0990UEKU $107.91 E0992NU $85.06 E0992NUKU $129.85 E0992RR $8.51 E0992RRKU $10.81 E0992UE $63.79

70

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E0992UEKU $97.39 E0994NU $24.06 E0994RR $2.43 E0994UE $18.04 E0995NU $30.39 E0995NUKU $30.38 E0995RR $3.13 E0995RRKU $3.15 E0995UE $22.77 E0995UEKU $22.77 E1002KH $372.39 E1002KHKU $372.39 E1002KI $372.39 E1002KIKU $372.39 E1002KJ $279.30 E1002KJKU $279.30 E1002NU $3,723.94 E1002NUKU $3,723.94 E1002UE $2,792.95 E1002UEKU $2,792.95 E1003KH $435.88 E1003KHKU $435.88 E1003KI $435.88 E1003KIKU $435.88 E1003KJ $326.91 E1003KJKU $326.91 E1003NU $4,358.80 E1003NUKU $4,358.80 E1003UE $3,269.10 E1003UEKU $3,269.10 E1004KH $479.09 E1004KHKU $479.09 E1004KI $479.09 E1004KIKU $479.09 E1004KJ $359.32 E1004KJKU $359.32

71

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1004NU $4,790.94 E1004NUKU $4,790.94 E1004UE $3,593.21 E1004UEKU $3,593.21 E1005KH $524.09 E1005KHKU $524.09 E1005KI $524.09 E1005KIKU $524.09 E1005KJ $393.07 E1005KJKU $393.07 E1005NU $5,240.93 E1005NUKU $5,240.93 E1005UE $3,930.70 E1005UEKU $3,930.70 E1006KH $645.30 E1006KHKU $645.30 E1006KI $645.30 E1006KIKU $645.30 E1006KJ $483.98 E1006KJKU $483.98 E1006NU $6,453.03 E1006NUKU $6,453.03 E1006UE $4,839.77 E1006UEKU $4,839.77 E1007KH $802.10 E1007KHKU $802.10 E1007KI $802.10 E1007KIKU $802.10 E1007KJ $601.58 E1007KJKU $601.58 E1007NU $8,021.03 E1007NUKU $8,021.03 E1007UE $6,015.77 E1007UEKU $6,015.77 E1008KH $822.74 E1008KHKU $822.74

72

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1008KI $822.74 E1008KIKU $822.74 E1008KJ $617.06 E1008KJKU $617.06 E1008NU $8,227.41 E1008NUKU $8,227.41 E1008UE $6,170.55 E1008UEKU $6,170.55 E1009NU AAC+ 35% E1009RR IC E1009UE IC E1010KH $111.81 E1010KHKU $111.81 E1010KI $111.81 E1010KIKU $111.81 E1010KJ $83.86 E1010KJKU $83.86 E1010NU $1,118.09 E1010NUKU $1,118.09 E1010UE $838.57 E1010UEKU $838.57 E1011NU AAC+ 35% E1011RR IC E1011UE IC E1012KH $111.81 E1012KHKU $111.81 E1012KI $111.81 E1012KIKU $111.81 E1012KJ $83.86 E1012KJKU $83.86 E1012NU $1,118.09 E1012NUKU $1,118.09 E1012UE $838.57 E1012UEKU $838.57 E1014KH $42.36 E1014KI $42.36

73

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1014KJ $31.77 E1014NU $423.64 E1014UE $317.73 E1015NU $133.95 E1015NUKU $156.52 E1015RR $13.39 E1015RRKU $15.65 E1015UE $100.47 E1015UEKU $117.38 E1016NU $132.50 E1016NUKU $154.44 E1016RR $13.25 E1016RRKU $15.47 E1016UE $99.38 E1016UEKU $115.81 E1017NU AAC+ 35% E1017RR IC E1017UE IC E1018NU AAC+ 35% E1018RR IC E1018UE IC E1020KH $17.08 E1020KHKU $17.08 E1020KI $17.08 E1020KIKU $17.08 E1020KJ $12.81 E1020KJKU $12.81 E1020NU $170.77 E1020NUKU $170.77 E1020UE $128.07 E1020UEKU $128.07 E1022NU AAC+ 35% E1023NU AAC+ 35% E1028KH $13.33 E1028KHKU $13.33 E1028KI $13.33

74

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1028KIKU $13.33 E1028KJ $10.00 E1028KJKU $10.00 E1028NU $133.28 E1028NUKU $133.28 E1028UE $99.96 E1028UEKU $99.96 E1029KH $36.92 E1029KHKU $36.92 E1029KI $36.92 E1029KIKU $36.92 E1029KJ $27.69 E1029KJKU $27.69 E1029NU $369.24 E1029NUKU $369.24 E1029UE $276.93 E1029UEKU $276.93 E1030KH $116.48 E1030KHKU $116.48 E1030KI $116.48 E1030KIKU $116.48 E1030KJ $87.36 E1030KJKU $87.36 E1030NU $1,164.84 E1030NUKU $1,164.84 E1030UE $873.63 E1030UEKU $873.63 E1031KH $39.82 E1031KI $39.82 E1031KJ $29.87 E1031NU $398.23 E1031UE $298.67 E1032KH $13.73 E1032KHKU $13.73 E1032KI $13.73 E1032KIKU $13.73

75

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1032KJ $10.30 E1032KJKU $10.30 E1032NU $137.28 E1032NUKU $137.28 E1032UE $102.96 E1032UEKU $102.96 E1033KH $13.73 E1033KHKU $13.73 E1033KI $13.73 E1033KIKU $13.73 E1033KJ $10.30 E1033KJKU $10.30 E1033NU $137.28 E1033NUKU $137.28 E1033UE $102.96 E1033UEKU $102.96 E1034KH $13.73 E1034KHKU $13.73 E1034KI $13.73 E1034KIKU $13.73 E1034KJ $10.30 E1034KJKU $10.30 E1034NU $137.28 E1034NUKU $137.28 E1034UE $102.96 E1034UEKU $102.96 E1035KH $563.37 E1035KI $563.37 E1035KJ $422.53 E1035NU $5,633.72 E1035UE $4,225.29 E1036KH $859.17 E1036KI $859.17 E1036KJ $644.38 E1036NU $8,591.72 E1036UE $6,443.79

76

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1037KH $109.15 E1037KI $109.15 E1037KJ $81.86 E1037NU $1,091.49 E1037UE $818.61 E1038KH $13.68 E1038KI $13.68 E1038KJ $10.26 E1038NU $136.77 E1038UE $102.57 E1039KH $31.59 E1039KI $31.59 E1039KJ $23.70 E1039NU $315.95 E1039UE $236.96 E1050KH $100.40 E1050KI $100.40 E1050KJ $75.30 E1050NU $1,004.02 E1050UE $753.02 E1060KH $146.20 E1060KI $146.20 E1060KJ $109.65 E1060NU $1,462.00 E1060UE $1,096.50 E1070KH $127.04 E1070KI $127.04 E1070KJ $95.28 E1070NU $1,270.41 E1070UE $952.81 E1083KH $84.33 E1083KI $84.33 E1083KJ $63.25 E1083NU $843.29 E1083UE $632.46 E1084KH $112.00

77

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1084KI $112.00 E1084KJ $84.00 E1084NU $1,119.96 E1084UE $839.97 E1087KH $146.75 E1087KI $146.75 E1087KJ $110.06 E1087NU $1,467.53 E1087UE $1,100.64 E1088KH $174.86 E1088KI $174.86 E1088KJ $131.15 E1088NU $1,748.62 E1088UE $1,311.47 E1092KH $126.69 E1092KI $126.69 E1092KJ $95.02 E1092NU $1,266.93 E1092UE $950.19 E1093KH $108.95 E1093KI $108.95 E1093KJ $81.71 E1093NU $1,089.53 E1093UE $817.15 E1100KH $120.39 E1100KI $120.39 E1100KJ $90.29 E1100NU $1,203.86 E1100UE $902.89 E1110KH $117.89 E1110KI $117.89 E1110KJ $88.41 E1110NU $1,178.87 E1110UE $884.15 E1150KH $94.61 E1150KI $94.61

78

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1150KJ $70.95 E1150NU $946.05 E1150UE $709.54 E1160KH $72.50 E1160KI $72.50 E1160KJ $54.37 E1160NU $724.97 E1160UE $543.72 E1161KH $274.41 E1161KI $274.41 E1161KJ $205.80 E1161NU $2,744.06 E1161UE $2,058.04 E1170KH $103.60 E1170KI $103.60 E1170KJ $77.70 E1170NU $1,035.98 E1170UE $776.99 E1171KH $92.96 E1171KI $92.96 E1171KJ $69.72 E1171NU $929.56 E1171UE $697.17 E1172KH $113.64 E1172KI $113.64 E1172KJ $85.23 E1172NU $1,136.37 E1172UE $852.27 E1180KH $117.53 E1180KI $117.53 E1180KJ $88.15 E1180NU $1,175.30 E1180UE $881.47 E1190KH $125.18 E1190KI $125.18 E1190KJ $93.88

79

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1190NU $1,251.80 E1190UE $938.85 E1195KH $145.69 E1195KI $145.69 E1195KJ $109.27 E1195NU $1,456.90 E1195UE $1,092.68 E1200KH $100.91 E1200KI $100.91 E1200KJ $75.68 E1200NU $1,009.12 E1200UE $756.84 E1221KH $55.11 E1221KI $55.11 E1221KJ $41.33 E1221NU $551.06 E1221UE $413.29 E1222KH $78.60 E1222KI $78.60 E1222KJ $58.95 E1222NU $786.00 E1222UE $589.50 E1223KH $85.84 E1223KI $85.84 E1223KJ $64.38 E1223NU $858.42 E1223UE $643.81 E1224KH $94.12 E1224KI $94.12 E1224KJ $70.59 E1224NU $941.21 E1224UE $705.90 E1225KH $34.67 E1225KHKU $34.67 E1225KI $34.67 E1225KIKU $34.67

80

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1225KJ $26.00 E1225KJKU $26.00 E1225NU $346.72 E1225NUKU $346.72 E1225UE $260.04 E1225UEKU $260.04 E1226NU $351.26 E1226NUKU $632.83 E1226RR $35.13 E1226RRKU $65.12 E1226UE $263.45 E1226UEKU $474.57 E1227NU $321.84 E1227RR $32.19 E1227UE $241.42 E1228KH $32.50 E1228KI $32.50 E1228KJ $24.38 E1228NU $325.04 E1228UE $243.78 E1229 AAC+ 35% E1230NU $2,623.20 E1230RR $303.53 E1230UE $2,440.75 E1231NU AAC+ 35% E1231RR IC E1231UE IC E1232KH $248.03 E1232KI $248.03 E1232KJ $186.02 E1232NU $2,480.30 E1232UE $1,860.23 E1233KH $256.96 E1233KI $256.96 E1233KJ $192.72 E1233NU $2,569.64

81

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1233UE $1,927.23 E1234KH $223.72 E1234KI $223.72 E1234KJ $167.79 E1234NU $2,237.20 E1234UE $1,677.90 E1235KH $215.43 E1235KI $215.43 E1235KJ $161.57 E1235NU $2,154.33 E1235UE $1,615.74 E1236KH $190.06 E1236KI $190.06 E1236KJ $142.55 E1236NU $1,900.60 E1236UE $1,425.45 E1237KH $191.71 E1237KI $191.71 E1237KJ $143.78 E1237NU $1,917.09 E1237UE $1,437.82 E1238KH $190.06 E1238KI $190.06 E1238KJ $142.55 E1238NU $1,900.60 E1238UE $1,425.45 E1239 AAC+ 35% E1240KH $119.49 E1240KI $119.49 E1240KJ $89.62 E1240NU $1,194.93 E1240UE $896.20 E1270KH $91.55 E1270KI $91.55 E1270KJ $68.67 E1270NU $915.54

82

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1270UE $686.65 E1280KH $152.23 E1280KI $152.23 E1280KJ $114.17 E1280NU $1,522.27 E1280UE $1,141.70 E1295KH $140.87 E1295KI $140.87 E1295KJ $105.65 E1295NU $1,408.71 E1295UE $1,056.53 E1296NU $670.83 E1296RR $68.17 E1296UE $503.14 E1297NU $121.32 E1297RR $13.48 E1297UE $90.98 E1298NU $491.35 E1298RR $50.27 E1298UE $368.51 E1300 AAC+ 30% E1301 AAC+ 30% E1310NU $2,116.95 E1310RR $181.05 E1310UE $1,587.70 E1352 AAC+ 20% E1353 $32.84 E1354 AAC+ 30% E1355 $24.75 E1356 AAC+ 30% E1357 AAC+ 30% E1358 AAC+ 30% E1372NU $124.83 E1372RR $12.49 E1372UE $93.63 E1390RR $79.98

83

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1391RR $79.98 E1392RR $40.83 E1399NU AAC+ 30% E1399RB AAC+ 30% E1399U1 AAC+ 35% E1399U3 AAC+ 30% E1399U4 AAC+ 30% E1399UC AAC+ 35% E1405RR $108.42 E1406RR $85.99 E1500 AAC+ 30% E1510 AAC+ 30% E1520 AAC+ 30% E1530 AAC+ 30% E1540 AAC+ 20% E1550 AAC+ 20% E1560 AAC+ 20% E1570 AAC+ 30% E1575 AAC+ 30% E1580 AAC+ 20% E1590 AAC+ 30% E1592 AAC+ 30% E1594 AAC+ 30% E1610 AAC+ 30% E1615 AAC+ 30% E1620 AAC+ 30% E1625 AAC+ 30% E1630 AAC+ 30% E1632 AAC+ 30% E1634 AAC+ 30% E1635 AAC+ 30% E1636 AAC+ 30% E1637 AAC+ 30% E1639 AAC+ 30% E1699 AAC+ 30% E1700KH $36.21

84

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1700KI $36.21 E1700KJ $27.16 E1700NU $362.10 E1700UE $271.58 E1701 $12.03 E1702 $26.16 E1800KH $120.77 E1800KI $120.77 E1800KJ $90.58 E1800NU $1,207.68 E1800UE $905.76 E1801KH $149.63 E1801KI $149.63 E1801KJ $112.22 E1801NU $1,496.26 E1801UE $1,122.19 E1802KH $379.03 E1802KI $379.03 E1802KJ $284.27 E1802NU $3,790.32 E1802UE $2,842.74 E1803KH $145.49 E1803KI $145.49 E1803KJ $109.12 E1803NU $1,454.90 E1803UE $1,091.18 E1804KH $145.49 E1804KI $145.49 E1804KJ $109.12 E1804NU $1,454.90 E1804UE $1,091.18 E1805KH $146.54 E1805KI $146.54 E1805KJ $109.91 E1805NU $1,465.40 E1805UE $1,099.05

85

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1806KH $122.86 E1806KI $122.86 E1806KJ $92.14 E1806NU $1,228.59 E1806UE $921.44 E1807KH $176.54 E1807KI $176.54 E1807KJ $132.41 E1807NU $1,765.40 E1807UE $1,324.05 E1808KH $176.54 E1808KI $176.54 E1808KJ $132.41 E1808NU $1,765.40 E1808UE $1,324.05 E1810KH $122.83 E1810KI $122.83 E1810KJ $92.12 E1810NU $1,228.25 E1810UE $921.19 E1811KH $155.54 E1811KI $155.54 E1811KJ $116.66 E1811NU $1,555.42 E1811UE $1,166.56 E1812KH $99.73 E1812KI $99.73 E1812KJ $74.80 E1812NU $997.31 E1812UE $747.98 E1813KH $147.97 E1813KI $147.97 E1813KJ $110.98 E1813NU $1,479.70 E1813UE $1,109.78 E1814KH $147.97

86

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1814KI $147.97 E1814KJ $110.98 E1814NU $1,479.70 E1814UE $1,109.78 E1815KH $146.54 E1815KI $146.54 E1815KJ $109.91 E1815NU $1,465.40 E1815UE $1,099.05 E1816KH $158.02 E1816KI $158.02 E1816KJ $118.51 E1816NU $1,580.15 E1816UE $1,185.11 E1818KH $161.30 E1818KI $161.30 E1818KJ $120.98 E1818NU $1,613.05 E1818UE $1,209.78 E1820NU $94.81 E1820RR $9.46 E1820UE $71.12 E1821NU $122.05 E1821RR $12.17 E1821UE $91.57 E1822KH $176.54 E1822KI $176.54 E1822KJ $132.41 E1822NU $1,765.40 E1822UE $1,324.05 E1823KH $176.54 E1823KI $176.54 E1823KJ $132.41 E1823NU $1,765.40 E1823UE $1,324.05 E1825KH $146.54

87

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1825KI $146.54 E1825KJ $109.91 E1825NU $1,465.40 E1825UE $1,099.05 E1826KH $176.54 E1826KI $176.54 E1826KJ $132.41 E1826NU $1,765.40 E1826UE $1,324.05 E1827KH $176.54 E1827KI $176.54 E1827KJ $132.41 E1827NU $1,765.40 E1827UE $1,324.05 E1828KH $176.54 E1828KI $176.54 E1828KJ $132.41 E1828NU $1,765.40 E1828UE $1,324.05 E1829KH $176.54 E1829KI $176.54 E1829KJ $132.41 E1829NU $1,765.40 E1829UE $1,324.05 E1830KH $146.54 E1830KI $146.54 E1830KJ $109.91 E1830NU $1,465.40 E1830UE $1,099.05 E1831KH $73.70 E1831KI $73.70 E1831KJ $55.27 E1831NU $736.95 E1831UE $552.71 E1832KH $75.46 E1832KI $75.46

88

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E1832KJ $56.60 E1832NU $754.63 E1832UE $565.97 E1840KH $443.87 E1840KI $443.87 E1840KJ $332.90 E1840NU $4,438.70 E1840UE $3,329.03 E1841KH $525.37 E1841KI $525.37 E1841KJ $394.03 E1841NU $5,253.68 E1841UE $3,940.26 E1902 AAC+ 30% E1905 $549.13 E2000KH $60.11 E2000KI $60.11 E2000KJ $45.08 E2000NU $601.12 E2000UE $450.84 E2001KH $62.47 E2001KI $62.47 E2001KJ $46.85 E2001NU $624.70 E2001UE $468.53 E2100NU $745.94 E2100RR $74.61 E2100UE $559.48 E2101NU $218.68 E2101RR $21.87 E2101UE $164.02 E2102NUKF $171.89 E2102RRKF $17.20 E2102UEKF $128.91 E2103NU $264.25 E2103NUCG $264.25

89

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2103NUKF $293.39 E2103NUKFCG $293.39 E2103RR $26.43 E2103RRCG $26.43 E2103RRKF $29.34 E2103RRKFCG $29.34 E2103UE $198.19 E2103UECG $198.19 E2103UEKF $220.03 E2103UEKFCG $220.03 E2120KH $328.82 E2120KI $328.82 E2120KJ $246.62 E2120NU $3,288.23 E2120UE $2,466.17 E2201NU $332.87 E2201NUKU $509.09 E2201RR $33.29 E2201RRKU $50.92 E2201UE $249.65 E2201UEKU $381.81 E2202NU $492.15 E2202NUKU $646.71 E2202RR $49.22 E2202RRKU $64.68 E2202UE $369.11 E2202UEKU $485.05 E2203NU $466.63 E2203NUKU $653.64 E2203RR $46.66 E2203RRKU $65.36 E2203UE $349.98 E2203UEKU $490.19 E2204NU $814.88 E2204NUKU $1,109.85 E2204RR $81.49

90

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2204RRKU $111.00 E2204UE $611.16 E2204UEKU $832.38 E2205NU $41.41 E2205NUKU $44.58 E2205RR $4.14 E2205RRKU $4.44 E2205UE $31.06 E2205UEKU $33.46 E2206NU $42.54 E2206NUKU $55.49 E2206RR $4.25 E2206RRKU $5.52 E2206UE $31.90 E2206UEKU $41.62 E2207NU $47.42 E2207NUKU $59.14 E2207RR $4.74 E2207RRKU $5.93 E2207UE $35.57 E2207UEKU $44.37 E2208NU $66.79 E2208NUKU $139.70 E2208RR $6.68 E2208RRKU $13.96 E2208UE $50.10 E2208UEKU $104.78 E2209NU $101.29 E2209NUKU $126.01 E2209RR $10.13 E2209RRKU $12.62 E2209UE $75.97 E2209UEKU $94.53 E2210NU $5.47 E2210NUKU $7.68 E2210RR $0.55

91

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2210RRKU $0.65 E2210UE $4.10 E2210UEKU $5.79 E2211NU $40.10 E2211NUKU $55.83 E2211RR $4.01 E2211RRKU $5.39 E2211UE $30.08 E2211UEKU $39.99 E2212NU $7.46 E2212NUKU $8.00 E2212RR $0.75 E2212RRKU $0.86 E2212UE $5.60 E2212UEKU $6.02 E2213NU $35.75 E2213NUKU $41.51 E2213RR $3.58 E2213RRKU $4.18 E2213UE $26.82 E2213UEKU $31.11 E2214NU $40.12 E2214NUKU $49.11 E2214RR $4.01 E2214RRKU $5.39 E2214UE $30.09 E2214UEKU $36.81 E2215NU $12.25 E2215NUKU $13.09 E2215RR $1.23 E2215RRKU $1.30 E2215UE $9.19 E2215UEKU $9.82 E2216NU $50.43 E2216NUKU $62.16 E2216RR $5.04

92

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2216RRKU $6.22 E2216UE $37.82 E2216UEKU $46.61 E2217NU $44.63 E2217NUKU $54.99 E2217RR $4.46 E2217RRKU $5.48 E2217UE $33.47 E2217UEKU $41.27 E2218NU $50.43 E2218NUKU $62.16 E2218RR $5.04 E2218RRKU $6.22 E2218UE $37.82 E2218UEKU $46.61 E2219NU $44.63 E2219NUKU $54.99 E2219RR $4.46 E2219RRKU $5.48 E2219UE $33.47 E2219UEKU $41.27 E2220NU $35.88 E2220NUKU $38.94 E2220RR $3.59 E2220RRKU $3.76 E2220UE $26.92 E2220UEKU $29.77 E2221NU $31.50 E2221NUKU $34.86 E2221RR $3.15 E2221RRKU $3.54 E2221UE $23.63 E2221UEKU $26.15 E2222NU $25.88 E2222NUKU $28.75 E2222RR $2.59

93

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2222RRKU $2.83 E2222UE $19.41 E2222UEKU $21.57 E2224NU $119.17 E2224NUKU $133.80 E2224RR $11.92 E2224RRKU $14.05 E2224UE $89.38 E2224UEKU $100.35 E2225NU $22.41 E2225NUKU $23.73 E2225RR $2.24 E2225RRKU $2.35 E2225UE $16.80 E2225UEKU $17.79 E2226NU $46.40 E2226NUKU $51.76 E2226RR $4.64 E2226RRKU $5.18 E2226UE $34.80 E2226UEKU $38.83 E2227KH $208.60 E2227KI $208.60 E2227KJ $156.45 E2227NU $2,085.99 E2227UE $1,564.49 E2228KH $94.41 E2228KHKU $94.41 E2228KI $94.41 E2228KIKU $94.41 E2228KJ $70.81 E2228KJKU $70.81 E2228NU $944.10 E2228NUKU $944.10 E2228UE $708.07 E2228UEKU $708.07

94

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2230 AAC+ 35% E2231NU $153.64 E2231NUKU $209.68 E2231RR $15.36 E2231RRKU $20.98 E2231UE $115.24 E2231UEKU $157.24 E2291 AAC+ 35% E2292 AAC+ 35% E2293 AAC+ 35% E2294 AAC+ 35% E2295 AAC+ 35% E2298KH $201.39 E2298KI $201.39 E2298KJ $151.04 E2298NU $2,013.90 E2298UE $1,510.43 E2300 AAC+ 35% E2301 AAC+ 35% E2310KH $128.29 E2310KHKU $128.29 E2310KI $128.29 E2310KIKU $128.29 E2310KJ $51.32 E2310KJKU $51.32 E2310NU $855.27 E2310NUKU $855.27 E2310UE $641.45 E2310UEKU $641.45 E2311KH $258.88 E2311KHKU $258.88 E2311KI $258.88 E2311KIKU $258.88 E2311KJ $103.55 E2311KJKU $103.55 E2311NU $1,725.87

95

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2311NUKU $1,725.87 E2311UE $1,294.40 E2311UEKU $1,294.40 E2312KH $264.60 E2312KHKC $264.60 E2312KI $264.60 E2312KIKC $264.60 E2312KJ $105.84 E2312KJKC $105.84 E2312NU $1,764.00 E2312NUKC $1,764.00 E2312UE $1,323.00 E2312UEKC $1,323.00 E2313KH $42.05 E2313KI $42.05 E2313KJ $16.82 E2313NU $280.33 E2313UE $210.25 E2321KH $174.31 E2321KHKC $174.31 E2321KHKU $174.31 E2321KI $174.31 E2321KIKC $174.31 E2321KIKU $174.31 E2321KJ $69.72 E2321KJKC $69.72 E2321KJKU $69.72 E2321NU $1,162.07 E2321NUKC $1,162.07 E2321NUKU $1,162.07 E2321UE $871.55 E2321UEKC $871.55 E2321UEKU $871.55 E2322KH $164.68 E2322KHKC $164.68 E2322KHKU $164.68

96

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2322KI $164.68 E2322KIKC $164.68 E2322KIKU $164.68 E2322KJ $164.68 E2322KJKC $65.87 E2322KJKU $65.87 E2322NU $1,097.87 E2322NUKC $1,097.87 E2322NUKU $1,097.87 E2322UE $823.40 E2322UEKC $823.40 E2322UEKU $823.40 E2323NU $80.27 E2323NUKU $81.35 E2323RR $8.03 E2323RRKU $8.11 E2323UE $60.21 E2323UEKU $60.99 E2324NU $51.53 E2324NUKU $51.53 E2324RR $5.13 E2324RRKU $5.13 E2324UE $38.65 E2324UEKU $38.64 E2325KH $157.39 E2325KHKU $157.39 E2325KI $157.39 E2325KIKU $157.39 E2325KJ $62.96 E2325KJKU $62.96 E2325NU $1,049.27 E2325NUKU $1,049.27 E2325UE $786.95 E2325UEKU $786.95 E2326KH $40.84 E2326KHKU $40.84

97

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2326KI $40.84 E2326KIKU $40.84 E2326KJ $16.34 E2326KJKU $16.34 E2326NU $272.27 E2326NUKU $272.27 E2326UE $204.20 E2326UEKU $204.20 E2327KH $307.21 E2327KHKC $307.21 E2327KHKU $307.21 E2327KI $307.21 E2327KIKC $307.21 E2327KIKU $307.21 E2327KJ $122.88 E2327KJKC $122.88 E2327KJKU $122.88 E2327NU $2,048.07 E2327NUKC $2,048.07 E2327NUKU $2,048.07 E2327UE $1,536.05 E2327UEKC $1,536.05 E2327UEKU $1,536.05 E2328KH $581.11 E2328KHKU $581.11 E2328KI $581.11 E2328KIKU $581.11 E2328KJ $232.44 E2328KJKU $232.44 E2328NU $3,874.07 E2328NUKU $3,874.07 E2328UE $2,905.55 E2328UEKU $2,905.55 E2329KH $207.70 E2329KHKU $207.70 E2329KI $207.70

98

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2329KIKU $207.70 E2329KJ $83.08 E2329KJKU $83.08 E2329NU $1,384.67 E2329NUKU $1,384.67 E2329UE $1,038.50 E2329UEKU $1,038.50 E2330KH $402.43 E2330KHKU $402.43 E2330KI $402.43 E2330KIKU $402.43 E2330KJ $160.97 E2330KJKU $160.97 E2330NU $2,682.87 E2330NUKU $2,682.87 E2330UE $2,012.15 E2330UEKU $2,012.15 E2331NU AAC+ 35% E2331RR IC E2331UE IC E2340NU $488.95 E2340RR $48.92 E2340UE $366.76 E2341NU $733.50 E2341RR $73.34 E2341UE $550.15 E2342NU $611.26 E2342RR $61.12 E2342UE $458.45 E2343NU $978.02 E2343RR $97.79 E2343UE $733.50 E2351NU $821.90 E2351NUKU $821.61 E2351RR $82.19 E2351RRKU $82.19

99

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2351UE $616.42 E2351UEKU $616.18 E2358NU AAC+ 35% E2358RR IC E2358UE IC E2359NU $183.30 E2359NUKU $228.44 E2359RR $18.33 E2359RRKU $22.84 E2359UE $137.48 E2359UEKU $171.32 E2360NU $148.73 E2360NUKU $153.29 E2360RR $14.87 E2360RRKU $15.41 E2360UE $111.55 E2360UEKU $114.95 E2361NU $140.23 E2361NUKU $164.03 E2361RR $14.03 E2361RRKU $16.40 E2361UE $105.17 E2361UEKU $123.03 E2362NU $125.51 E2362NUKU $125.50 E2362RR $12.55 E2362RRKU $12.56 E2362UE $94.13 E2362UEKU $94.10 E2363NU $169.10 E2363NUKU $218.74 E2363RR $16.91 E2363RRKU $21.87 E2363UE $126.83 E2363UEKU $164.06 E2364NU $131.21

100

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2364NUKU $153.29 E2364RR $13.12 E2364RRKU $15.41 E2364UE $98.41 E2364UEKU $114.95 E2365NU $90.20 E2365NUKU $131.90 E2365RR $9.02 E2365RRKU $13.17 E2365UE $67.65 E2365UEKU $98.98 E2366NU $164.00 E2366NUKU $310.02 E2366RR $16.40 E2366RRKU $31.10 E2366UE $123.00 E2366UEKU $232.54 E2367NU $429.60 E2367NUKU $492.84 E2367RR $42.96 E2367RRKU $49.26 E2367UE $322.20 E2367UEKU $369.65 E2368KH $47.16 E2368KHKU $47.16 E2368KI $47.16 E2368KIKU $47.16 E2368KJ $18.86 E2368KJKU $18.86 E2368NU $314.40 E2368NUKU $314.40 E2368UE $235.80 E2368UEKU $235.80 E2369KH $46.86 E2369KHKU $46.86 E2369KI $46.86

101

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2369KIKU $46.86 E2369KJ $18.74 E2369KJKU $18.74 E2369NU $312.40 E2369NUKU $312.40 E2369UE $234.30 E2369UEKU $234.30 E2370KH $61.70 E2370KHKU $61.70 E2370KI $61.70 E2370KIKU $61.70 E2370KJ $24.68 E2370KJKU $24.68 E2370NU $411.33 E2370NUKU $411.33 E2370UE $308.50 E2370UEKU $308.50 E2371NU $166.91 E2371NUKU $177.27 E2371RR $16.69 E2371RRKU $17.73 E2371UE $125.18 E2371UEKU $132.97 E2372NU AAC+ 35% E2372RR IC E2372UE IC E2373KH $92.25 E2373KHKC $92.25 E2373KHKU $92.25 E2373KI $92.25 E2373KIKC $92.25 E2373KIKU $92.25 E2373KJ $36.90 E2373KJKC $36.90 E2373KJKU $36.90 E2373NU $615.00

102

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2373NUKC $615.00 E2373NUKU $615.00 E2373UE $461.25 E2373UEKC $461.25 E2373UEKU $461.25 E2374KH $59.11 E2374KHKU $59.11 E2374KI $59.11 E2374KIKU $59.11 E2374KJ $23.64 E2374KJKU $23.64 E2374NU $394.07 E2374NUKU $394.07 E2374UE $295.55 E2374UEKU $295.55 E2375KH $79.04 E2375KHKU $79.04 E2375KI $79.04 E2375KIKU $79.04 E2375KJ $31.62 E2375KJKU $31.62 E2375NU $526.93 E2375NUKU $526.93 E2375UE $395.20 E2375UEKU $395.20 E2376KH $146.86 E2376KHKU $146.86 E2376KI $146.86 E2376KIKU $146.86 E2376KJ $58.74 E2376KJKU $58.74 E2376NU $979.07 E2376NUKU $979.07 E2376UE $734.30 E2376UEKU $734.30 E2377KH $54.40

103

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2377KHKU $54.40 E2377KI $54.40 E2377KIKU $54.40 E2377KJ $21.76 E2377KJKU $21.76 E2377NU $362.67 E2377NUKU $362.67 E2377UE $272.00 E2377UEKU $272.00 E2378KH $67.91 E2378KHKU $67.91 E2378KI $67.91 E2378KIKU $67.91 E2378KJ $27.16 E2378KJKU $27.16 E2378NU $452.73 E2378NUKU $452.73 E2378UE $339.55 E2378UEKU $339.55 E2381NU $70.94 E2381NUKU $89.58 E2381RR $7.09 E2381RRKU $8.99 E2381UE $53.21 E2381UEKU $67.17 E2382NU $21.55 E2382NUKU $24.41 E2382RR $2.15 E2382RRKU $2.43 E2382UE $16.17 E2382UEKU $18.32 E2383NU $157.03 E2383NUKU $178.61 E2383RR $15.70 E2383RRKU $17.86 E2383UE $117.77

104

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2383UEKU $133.95 E2384NU $65.17 E2384NUKU $95.15 E2384RR $6.52 E2384RRKU $9.54 E2384UE $48.88 E2384UEKU $71.38 E2385NU $51.71 E2385NUKU $58.20 E2385RR $5.17 E2385RRKU $5.84 E2385UE $38.78 E2385UEKU $43.64 E2386NU $102.99 E2386NUKU $176.99 E2386RR $10.30 E2386RRKU $17.70 E2386UE $77.25 E2386UEKU $132.76 E2387NU $52.58 E2387NUKU $79.36 E2387RR $5.26 E2387RRKU $7.94 E2387UE $39.44 E2387UEKU $59.57 E2388NU $56.27 E2388NUKU $59.24 E2388RR $5.63 E2388RRKU $5.93 E2388UE $42.20 E2388UEKU $44.46 E2389NU $31.45 E2389NUKU $32.18 E2389RR $3.14 E2389RRKU $3.23 E2389UE $23.59

105

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2389UEKU $24.11 E2390NU $48.69 E2390NUKU $50.33 E2390RR $4.87 E2390RRKU $5.04 E2390UE $36.52 E2390UEKU $37.72 E2391NU $21.39 E2391NUKU $24.10 E2391RR $2.14 E2391RRKU $2.42 E2391UE $16.04 E2391UEKU $18.08 E2392NU $45.99 E2392NUKU $63.36 E2392RR $4.60 E2392RRKU $6.38 E2392UE $34.49 E2392UEKU $47.53 E2394NU $67.85 E2394NUKU $90.28 E2394RR $6.79 E2394RRKU $9.05 E2394UE $50.89 E2394UEKU $67.71 E2395NU $46.04 E2395NUKU $64.15 E2395RR $4.61 E2395RRKU $6.43 E2395UE $34.53 E2395UEKU $48.11 E2396NU $65.98 E2396NUKU $75.35 E2396RR $6.60 E2396RRKU $8.36 E2396UE $49.48

106

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2396UEKU $56.54 E2397NU $531.23 E2397NUKU $565.06 E2397RR $53.12 E2397RRKU $56.52 E2397UE $398.42 E2397UEKU $423.77 E2398NU $156.52 E2398NUKU $156.52 E2398RR $15.65 E2398RRKU $15.65 E2398UE $117.38 E2398UEKU $117.38 E2402KH $601.27 E2402KI $601.27 E2402KJ $450.95 E2402NU $6,012.73 E2402UE $4,509.55 E2500NU $453.53 E2500RR $45.36 E2500UE $340.14 E2502NU $1,386.85 E2502RR $138.70 E2502UE $1,040.15 E2504NU $1,829.46 E2504RR $182.96 E2504UE $1,372.10 E2506NU $2,682.52 E2506RR $268.24 E2506UE $2,011.85 E2508NU $4,148.08 E2508RR $414.81 E2508UE $3,111.07 E2510NU $7,849.68 E2510RR $784.97 E2510TW $0.00

107

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2510UE $5,887.24 E2511NU AAC+ 30% E2511RR IC E2511TW $0.00 E2511UE IC E2512NU AAC+ 30% E2512RR IC E2512TW $0.00 E2512UE IC E2513NU $3,654.79 E2513RR $365.49 E2513UE $2,741.10 E2599NU AAC+ 30% E2599RR AAC+ 30% E2599TW $0.00 E2599UE IC E2601NU $47.16 E2601NUKU $71.92 E2601RR $4.72 E2601RRKU $7.20 E2601UE $35.37 E2601UEKU $53.95 E2602NU $92.73 E2602NUKU $140.41 E2602RR $9.27 E2602RRKU $14.06 E2602UE $69.55 E2602UEKU $105.33 E2603NU $109.16 E2603NUKU $178.26 E2603RR $10.92 E2603RRKU $17.84 E2603UE $81.87 E2603UEKU $133.72 E2604NU $154.73 E2604NUKU $221.59

108

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2604RR $15.47 E2604RRKU $22.16 E2604UE $116.05 E2604UEKU $166.19 E2605NU $239.42 E2605NUKU $316.55 E2605RR $23.94 E2605RRKU $31.66 E2605UE $179.57 E2605UEKU $237.45 E2606NU $383.01 E2606NUKU $493.84 E2606RR $38.30 E2606RRKU $49.39 E2606UE $287.26 E2606UEKU $370.34 E2607NU $218.50 E2607NUKU $340.87 E2607RR $21.85 E2607RRKU $34.09 E2607UE $163.87 E2607UEKU $255.65 E2608NU $282.20 E2608NUKU $409.35 E2608RR $28.22 E2608RRKU $40.93 E2608UE $211.65 E2608UEKU $307.01 E2609NU AAC+ 35% E2609RR IC E2609UE IC E2610NU AAC+ 35% E2610RR IC E2610UE IC E2611NU $184.00 E2611NUKU $367.34

109

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2611RR $18.40 E2611RRKU $36.72 E2611UE $138.00 E2611UEKU $275.52 E2612NU $330.29 E2612NUKU $496.91 E2612RR $33.03 E2612RRKU $49.69 E2612UE $247.72 E2612UEKU $372.66 E2613NU $350.24 E2613NUKU $462.23 E2613RR $35.03 E2613RRKU $46.23 E2613UE $262.69 E2613UEKU $346.66 E2614NU $558.73 E2614NUKU $639.69 E2614RR $55.87 E2614RRKU $63.96 E2614UE $419.05 E2614UEKU $479.79 E2615NU $409.53 E2615NUKU $531.92 E2615RR $40.95 E2615RRKU $53.20 E2615UE $307.15 E2615UEKU $398.94 E2616NU $535.88 E2616NUKU $715.71 E2616RR $53.59 E2616RRKU $71.56 E2616UE $401.92 E2616UEKU $536.78 E2617NU AAC+ 35% E2617RR IC

110

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2617UE IC E2619NU $57.93 E2619NUKU $60.33 E2619RR $5.79 E2619RRKU $6.02 E2619UE $43.45 E2619UEKU $45.30 E2620NU $405.17 E2620NUKU $644.08 E2620RR $40.52 E2620RRKU $64.42 E2620UE $303.88 E2620UEKU $483.10 E2621NU $507.96 E2621NUKU $675.93 E2621RR $50.80 E2621RRKU $67.59 E2621UE $380.98 E2621UEKU $506.96 E2622NU $367.50 E2622NUKU $389.81 E2622RR $36.75 E2622RRKU $39.00 E2622UE $275.63 E2622UEKU $292.36 E2623NU $464.74 E2623NUKU $496.01 E2623RR $46.47 E2623RRKU $49.62 E2623UE $348.55 E2623UEKU $372.01 E2624NU $373.45 E2624NUKU $393.02 E2624RR $37.35 E2624RRKU $39.32 E2624UE $280.09

111

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2624UEKU $294.79 E2625NU $462.17 E2625NUKU $497.54 E2625RR $46.22 E2625RRKU $49.73 E2625UE $346.63 E2625UEKU $373.16 E2626NU $796.69 E2626NUKU $847.51 E2626RR $79.67 E2626RRKU $84.72 E2626UE $597.52 E2626UEKU $635.55 E2627NU $1,253.20 E2627NUKU $1,352.33 E2627RR $125.32 E2627RRKU $135.28 E2627UE $939.90 E2627UEKU $1,014.23 E2628NU $952.97 E2628NUKU $1,018.77 E2628RR $95.30 E2628RRKU $101.86 E2628UE $714.73 E2628UEKU $764.05 E2629NU $1,163.37 E2629NUKU $1,172.02 E2629RR $116.34 E2629RRKU $117.18 E2629UE $872.53 E2629UEKU $879.04 E2630NU $809.36 E2630NUKU $901.56 E2630RR $80.94 E2630RRKU $90.14 E2630UE $607.02

112

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) E2630UEKU $676.16 E2631NU $302.13 E2631NUKU $306.54 E2631RR $30.21 E2631RRKU $30.63 E2631UE $226.60 E2631UEKU $229.89 E2632NU $212.26 E2632NUKU $229.31 E2632RR $21.23 E2632RRKU $22.94 E2632UE $159.20 E2632UEKU $171.98 E2633NU $174.61 E2633NUKU $194.50 E2633RR $17.46 E2633RRKU $19.46 E2633UE $130.96 E2633UEKU $145.90 E3000KH $234.41 E3000KI $234.41 E3000KJ $175.81 E3000NU $2,344.10 E3000UE $1,758.08 E3200 AAC+ 30% E8000 AAC+ 35% E8001 AAC+ 35% E8002 AAC+ 35% G0333 $48.45 J0133 $0.03 J0134 $0.04 J0136 $0.04 J0137 $0.05 J0138 IC J0139 IC J0153 AAC+ 20%

113

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) J0173 $1.58 J0211 IC J0281 $1.11 J0285 $39.86 J0287 AAC+ 20% J0288 $12.92 J0289 $18.39 J0401 $5.95 J0651 IC J0652 IC J0666 $1.23 J0687 $0.92 J0870 IC J0872 $0.28 J0873 $0.02 J0882 AAC+ 20% J0893 IC J0895 $5.87 J1072 IC J1171 $0.07 J1250 $6.44 J1265 $0.67 J1271 $0.10 J1299 $38.09 J1307 IC J1308 $0.01 J1325 $14.00 J1414 IC J1455 $11.11 J1459 $41.37 J1551 $12.35 J1552 $124.86 J1554 $417.69 J1555 $14.36 J1557 $46.38 J1559 $11.21

114

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) J1561 $42.14 J1561JB $42.14 J1562 $9.69 J1566 $67.91 J1568 $40.58 J1569 $38.31 J1569JB $38.31 J1570 $27.21 J1572 AAC+ 20% J1574 IC J1575 $14.65 J1576 $59.30 J1597 IC J1598 IC J1599 AAC J1644AX AAC+ 20% J1748 IC J1749 IC J1806 $0.34 J1808 $0.05 J1811 $6.41 J1813 $13.20 J1815 AAC+ 30% J1817 $2.08 J1921 $1.81 J1938 $0.02 J2002 $0.0026 J2003 IC J2004 IC J2021 $12.19 J2175 $5.12 J2183 $1.36 J2184 $1.79 J2246 IC J2251 $0.15 J2252 IC

115

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) J2253 IC J2260 $43.84 J2267 $29.53 J2270 $2.76 J2272 $3.87 J2274 $8.91 J2281 $6.43 J2290 IC J2351 $38.41 J2373 $0.18 J2407 AAC+ 20% J2428 IC J2468 IC J2470 IC J2471 IC J2472 IC J2545 $72.94 J2599 $1.34 J2601 IC J2802 $8.96 J2804 $0.12 J2865 $0.05 J2919 $0.25 J3010 $0.71 J3090 AAC+ 20% J3244 IC J3247 $14.93 J3263 $33.38 J3285 $47.16 J3371 $5.05 J3372 $5.51 J3380 AAC+ 20% J3392 IC J3393 IC J3394 IC J3489 AAC+ 20%

116

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) J7340 $199.67 J7500 $1.56 J7501 $77.66 J7502 $1.86 J7503 $1.50 J7504 $3,385.20 J7505 $982.67 J7507 $0.20 J7508 $0.48 J7509 $0.21 J7510 $0.20 J7511 $812.61 J7512 $0.01 J7513 $447.39 J7514 IC J7515 $0.68 J7516 AAC+ 25% J7517 $0.14 J7518 $0.32 J7520 $1.13 J7521 $1.13 J7525 $215.57 J7527 $1.87 J7601 IC J7605KO AAC+ 20% J7606KO AAC+ 20% J7608KO AAC+ 20% J7609 $0.05 J7611 $0.14 J7612 $0.23 J7613KO AAC+ 20% J7614KO AAC+ 20% J7620 $0.16 J7626KO AAC+ 20% J7631KO AAC+ 20% J7639KO AAC+ 20%

117

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) J7644KO AAC+ 20% J7669KO $0.37 J7682KO AAC+ 20% J7686KO AAC+ 20% J7999 AAC J8501 $2.89 J8522 $0.05 J8530 $0.82 J8540 $0.06 J8541 IC J8610 $0.20 J8611 IC J8612 IC J8650 $28.99 J8655 $334.78 J8670 $2.65 J9000 $2.77 J9024 $26.24 J9026 IC J9028 $80.64 J9032 AAC+ 20% J9033 $1.53 J9038 IC J9039 $129.16 J9040 $21.37 J9046 IC J9054 IC J9065 $11.28 J9072 IC J9073 $0.67 J9076 IC J9100 $0.65 J9161 IC J9172 IC J9190 $2.74 J9200 $3,278.55

118

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) J9208 $21.86 J9271 AAC+ 20% J9292 IC J9294 $1.67 J9296 IC J9299 AAC+ 20% J9308 AAC+ 20% J9314 $9.35 J9322 IC J9329 IC J9360 $3.30 J9361 IC J9370 $7.22 J9390 AAC+ 20% J9393 IC K0001KH $20.27 K0001KI $20.27 K0001KJ $15.20 K0001NU $202.73 K0001UE $152.04 K0002KH $31.28 K0002KI $31.28 K0002KJ $23.46 K0002NU $312.80 K0002UE $234.60 K0003KH $30.18 K0003KI $30.18 K0003KJ $22.63 K0003NU $301.75 K0003UE $226.31 K0004KH $39.19 K0004KI $39.19 K0004KJ $29.39 K0004NU $391.85 K0004UE $293.89 K0005NU $2,144.18

119

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0005RR $214.40 K0005UE $1,608.08 K0006KH $55.26 K0006KI $55.26 K0006KJ $41.44 K0006NU $552.59 K0006UE $414.44 K0007KH $77.46 K0007KI $77.46 K0007KJ $58.10 K0007NU $774.61 K0007UE $580.95 K0008 AAC+ 35% K0009KH $82.89 K0009KI $82.89 K0009KJ $62.17 K0009NU $828.92 K0009UE $621.69 K0010KH $494.05 K0010KI $494.05 K0010KJ $370.54 K0010NU $4,940.54 K0010UE $3,705.41 K0011KH $594.12 K0011KHKF $594.12 K0011KI $594.12 K0011KIKF $594.12 K0011KJ $445.59 K0011KJKF $445.59 K0011NU $5,941.25 K0011NUKF $5,941.25 K0011UE $4,455.93 K0011UEKF $4,455.93 K0012KH $376.83 K0012KI $376.83 K0012KJ $282.62

120

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0012NU $3,768.31 K0012UE $2,826.23 K0013 AAC+ 35% K0015KH $12.40 K0015KHKU $12.40 K0015KI $12.40 K0015KIKU $12.40 K0015KJ $9.30 K0015KJKU $9.30 K0015NU $124.02 K0015NUKU $124.02 K0015UE $93.01 K0015UEKU $93.01 K0017NU $55.77 K0017NUKU $60.09 K0017RR $5.58 K0017RRKU $6.00 K0017UE $41.83 K0017UEKU $45.08 K0018NU $31.53 K0018NUKU $33.57 K0018RR $3.15 K0018RRKU $3.36 K0018UE $23.65 K0018UEKU $25.20 K0019NU $15.88 K0019NUKU $20.17 K0019RR $1.59 K0019RRKU $2.02 K0019UE $11.91 K0019UEKU $15.16 K0020NU $54.64 K0020NUKU $54.63 K0020RR $5.46 K0020RRKU $5.47 K0020UE $40.97

121

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0020UEKU $40.98 K0037NU $52.47 K0037NUKU $56.64 K0037RR $4.67 K0037RRKU $4.67 K0037UE $39.36 K0037UEKU $42.49 K0038NU $27.88 K0038NUKU $28.55 K0038RR $2.79 K0038RRKU $2.84 K0038UE $20.91 K0038UEKU $21.39 K0039NU $59.86 K0039NUKU $63.36 K0039RR $5.99 K0039RRKU $6.38 K0039UE $44.89 K0039UEKU $47.53 K0040NU $57.22 K0040NUKU $87.83 K0040RR $5.72 K0040RRKU $8.76 K0040UE $42.92 K0040UEKU $65.82 K0041NU $57.20 K0041NUKU $62.23 K0041RR $5.72 K0041RRKU $6.28 K0041UE $42.90 K0041UEKU $46.66 K0042NU $36.74 K0042NUKU $42.84 K0042RR $3.68 K0042RRKU $4.28 K0042UE $27.55

122

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0042UEKU $32.12 K0043NU $22.68 K0043NUKU $22.96 K0043RR $2.27 K0043RRKU $2.28 K0043UE $17.01 K0043UEKU $17.26 K0044NU $19.57 K0044NUKU $19.58 K0044RR $1.97 K0044RRKU $1.96 K0044UE $14.68 K0044UEKU $14.66 K0045NU $64.91 K0045NUKU $66.59 K0045RR $6.49 K0045RRKU $6.86 K0045UE $48.68 K0045UEKU $49.96 K0046NU $22.83 K0046NUKU $22.96 K0046RR $2.28 K0046RRKU $2.28 K0046UE $17.13 K0046UEKU $17.26 K0047NU $80.67 K0047NUKU $89.94 K0047RR $8.07 K0047RRKU $9.02 K0047UE $60.50 K0047UEKU $67.42 K0050NU $37.43 K0050NUKU $38.23 K0050RR $3.74 K0050RRKU $3.82 K0050UE $28.07

123

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0050UEKU $28.69 K0051NU $59.21 K0051NUKU $61.87 K0051RR $5.92 K0051RRKU $6.24 K0051UE $44.41 K0051UEKU $46.39 K0052NU $74.15 K0052NUKU $108.74 K0052RR $7.42 K0052RRKU $10.87 K0052UE $55.61 K0052UEKU $81.52 K0053NU $102.15 K0053NUKU $119.97 K0053RR $10.22 K0053RRKU $11.99 K0053UD AAC+ 35% K0053UE $76.61 K0053UEKU $89.97 K0056NU $107.14 K0056NUKU $129.77 K0056RR $10.71 K0056RRKU $12.99 K0056UE $80.35 K0056UEKU $97.35 K0065NU $56.57 K0065NUKU $60.64 K0065RR $5.66 K0065RRKU $6.06 K0065UE $42.43 K0065UEKU $45.50 K0069NU $110.16 K0069NUKU $136.36 K0069RR $11.02 K0069RRKU $14.20

124

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.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0069UE $82.62 K0069UEKU $102.26 K0070KH $14.42 K0070KHKU $14.42 K0070KI $14.42 K0070KIKU $14.42 K0070KJ $10.81 K0070KJKU $10.81 K0070NU $144.16 K0070NUKU $144.16 K0070UE $108.12 K0070UEKU $108.12 K0071NU $132.64 K0071NUKU $149.07 K0071RR $13.26 K0071RRKU $14.91 K0071UE $99.48 K0071UEKU $111.76 K0072NU $81.83 K0072NUKU $89.73 K0072RR $8.18 K0072RRKU $8.98 K0072UE $61.37 K0072UEKU $67.29 K0073NU $42.74 K0073NUKU $47.50 K0073RR $4.27 K0073RRKU $4.76 K0073UE $32.06 K0073UEKU $35.61 K0077NU $56.82 K0077NUKU $80.31 K0077RR $5.68 K0077RRKU $8.00 K0077UE $42.61 K0077UEKU $60.21

125

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0098NU $28.80 K0098NUKU $32.00 K0098RR $2.88 K0098RRKU $3.21 K0098UE $21.60 K0098UEKU $23.97 K0105NU $119.22 K0105NUKU $135.66 K0105RR $11.92 K0105RRKU $13.56 K0105UE $89.42 K0105UEKU $101.75 K0108NU AAC+ 35% K0108RA $47.03 K0108RB AAC+ 35% K0195KH $10.51 K0195KHKU $10.51 K0195KI $10.51 K0195KIKU $10.51 K0195KJ $7.89 K0195KJKU $7.89 K0195NU $105.15 K0195NUKU $105.15 K0195UE $78.86 K0195UEKU $78.86 K0455RR $307.18 K0462 IC K0552 $2.79 K0601NU $1.27 K0602NU $7.13 K0603NU $0.64 K0604NU $6.88 K0605NU $16.43 K0606KHKF $2,920.65 K0606KIKF $2,920.65 K0606KJKF $2,190.49

126

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0606NUKF $29,206.51 K0606UEKF $21,904.88 K0607KH $22.53 K0607KHKF $22.53 K0607KI $22.53 K0607KIKF $22.53 K0607KJ $16.90 K0607KJKF $16.90 K0607NU $225.34 K0607NUKF $225.34 K0607UE $169.00 K0607UEKF $169.00 K0608NU $140.57 K0608NUKF $156.08 K0608RR $14.08 K0608RRKF $15.63 K0608UE $105.43 K0608UEKF $117.05 K0609NU $934.87 K0609NUKF $1,037.96 K0669 AAC+ 35% K0730KH $199.94 K0730KI $199.94 K0730KJ $149.95 K0730NU $1,999.37 K0730UE $1,499.53 K0733NU $29.04 K0733NUKU $35.52 K0733RR $2.91 K0733RRKU $3.59 K0733UE $21.79 K0733UEKU $26.67 K0738RR $40.83 K0739RB $21.11 K0739RBU6 $21.11 K0739U3 $1,000.00

127

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0739U5 $46.33 K0739U7 $46.33 K0739UB $31.74 K0739UBU6 $24.83 K0740RB $24.83 K0743RR IC K0744 AAC+ 20% K0745 AAC+ 20% K0746 AAC+ 20% K0800NU $976.39 K0800RR $97.64 K0800UE $732.29 K0801NU $1,826.66 K0801RR $182.67 K0801UE $1,369.99 K0802NU $2,450.89 K0802RR $245.09 K0802UE $1,838.17 K0806NU $1,653.26 K0806RR $165.33 K0806UE $1,239.95 K0807NU $2,562.14 K0807RR $256.21 K0807UE $1,921.61 K0808NU $3,960.65 K0808RR $396.07 K0808UE $2,970.49 K0812NU AAC+ 35% K0812RR IC K0812UE IC K0813KH $305.10 K0813KI $305.10 K0813KJ $122.04 K0813NU $2,034.00 K0813UE $1,525.50 K0814KH $307.50

128

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0814KI $307.50 K0814KJ $123.00 K0814NU $2,050.00 K0814UE $1,537.50 K0815KH $347.74 K0815KI $347.74 K0815KJ $139.10 K0815NU $2,318.27 K0815UE $1,738.70 K0816KH $310.29 K0816KI $310.29 K0816KJ $124.12 K0816NU $2,068.60 K0816UE $1,551.45 K0820KH $307.61 K0820KI $307.61 K0820KJ $123.04 K0820NU $2,050.73 K0820UE $1,538.05 K0821KH $310.29 K0821KI $310.29 K0821KJ $124.12 K0821NU $2,068.60 K0821UE $1,551.45 K0822KH $347.74 K0822KI $347.74 K0822KJ $139.10 K0822NU $2,318.27 K0822UE $1,738.70 K0823KH $310.29 K0823KI $310.29 K0823KJ $124.12 K0823NU $2,068.60 K0823UE $1,551.45 K0824KH $452.59 K0824KI $452.59

129

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0824KJ $181.04 K0824NU $3,017.27 K0824UE $2,262.95 K0825KH $443.78 K0825KI $443.78 K0825KJ $177.51 K0825NU $2,958.53 K0825UE $2,218.90 K0826KH $790.16 K0826KI $790.16 K0826KJ $316.06 K0826NU $5,267.73 K0826UE $3,950.80 K0827KH $698.00 K0827KI $698.00 K0827KJ $279.20 K0827NU $4,653.33 K0827UE $3,490.00 K0828KH $1,092.67 K0828KI $1,092.67 K0828KJ $437.07 K0828NU $7,284.47 K0828UE $5,463.35 K0829KH $1,061.38 K0829KI $1,061.38 K0829KJ $424.55 K0829NU $7,075.87 K0829UE $5,306.90 K0830NU $3,914.10 K0830RR $391.41 K0830UE $2,935.58 K0831NU $3,914.10 K0831RR $391.41 K0831UE $2,935.58 K0835KH $424.79 K0835KI $424.79

130

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0835KJ $169.92 K0835NU $2,831.93 K0835UE $2,123.95 K0836KH $440.60 K0836KI $440.60 K0836KJ $176.24 K0836NU $2,937.33 K0836UE $2,203.00 K0837KH $544.85 K0837KI $544.85 K0837KJ $217.94 K0837NU $3,632.33 K0837UE $2,724.25 K0838KH $482.92 K0838KI $482.92 K0838KJ $193.17 K0838NU $3,219.47 K0838UE $2,414.60 K0839KH $723.74 K0839KI $723.74 K0839KJ $289.50 K0839NU $4,824.93 K0839UE $3,618.70 K0840KH $1,111.17 K0840KI $1,111.17 K0840KJ $444.47 K0840NU $7,407.80 K0840UE $5,555.85 K0841KH $478.70 K0841KI $478.70 K0841KJ $191.48 K0841NU $3,191.33 K0841UE $2,393.50 K0842KH $478.01 K0842KI $478.01 K0842KJ $191.20

131

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0842NU $3,186.73 K0842UE $2,390.05 K0843KH $567.46 K0843KI $567.46 K0843KJ $226.98 K0843NU $3,783.07 K0843UE $2,837.30 K0848KH $932.20 K0848KI $932.20 K0848KJ $372.88 K0848NU $6,214.67 K0848UE $4,661.00 K0849KH $896.24 K0849KI $896.24 K0849KJ $358.50 K0849NU $5,974.93 K0849UE $4,481.20 K0850KH $1,081.29 K0850KI $1,081.29 K0850KJ $432.52 K0850NU $7,208.60 K0850UE $5,406.45 K0851KH $1,039.68 K0851KI $1,039.68 K0851KJ $415.87 K0851NU $6,931.20 K0851UE $5,198.40 K0852KH $1,249.37 K0852KI $1,249.37 K0852KJ $499.75 K0852NU $8,329.13 K0852UE $6,246.85 K0853KH $1,283.43 K0853KI $1,283.43 K0853KJ $513.37 K0853NU $8,556.20

132

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0853UE $6,417.15 K0854KH $1,700.26 K0854KI $1,700.26 K0854KJ $680.10 K0854NU $11,335.07 K0854UE $8,501.30 K0855KH $1,606.14 K0855KI $1,606.14 K0855KJ $642.46 K0855NU $10,707.60 K0855UE $8,030.70 K0856KH $1,000.59 K0856KI $1,000.59 K0856KJ $400.24 K0856NU $6,670.60 K0856UE $5,002.95 K0857KH $1,020.65 K0857KI $1,020.65 K0857KJ $408.26 K0857NU $6,804.33 K0857UE $5,103.25 K0858KH $1,241.45 K0858KI $1,241.45 K0858KJ $496.58 K0858NU $8,276.33 K0858UE $6,207.25 K0859KH $1,183.96 K0859KI $1,183.96 K0859KJ $473.58 K0859NU $7,893.07 K0859UE $5,919.80 K0860KH $1,773.57 K0860KI $1,773.57 K0860KJ $709.43 K0860NU $11,823.80 K0860UE $8,867.85

133

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0861KH $1,002.20 K0861KHKF $1,002.20 K0861KI $1,002.20 K0861KIKF $1,002.20 K0861KJ $400.88 K0861KJKF $400.88 K0861NU $6,681.33 K0861NUKF $6,681.33 K0861UE $5,011.00 K0861UEKF $5,011.00 K0862KH $1,241.45 K0862KI $1,241.45 K0862KJ $496.58 K0862NU $8,276.33 K0862UE $6,207.25 K0863KH $1,773.57 K0863KI $1,773.57 K0863KJ $709.43 K0863NU $11,823.80 K0863UE $8,867.85 K0864KH $2,110.55 K0864KI $2,110.55 K0864KJ $844.22 K0864NU $14,070.33 K0864UE $10,552.75 K0868NU AAC+ 35% K0868RR IC K0868UE IC K0869NU AAC+ 35% K0869RR IC K0869UE IC K0870NU AAC+ 35% K0870RR IC K0870UE IC K0871NU AAC+ 35% K0871RR IC

134

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K0871UE IC K0877NU AAC+ 35% K0877RR IC K0877UE IC K0878NU AAC+ 35% K0878RR IC K0878UE IC K0879NU AAC+ 35% K0879RR IC K0879UE IC K0880NU AAC+ 35% K0880RR IC K0880UE IC K0884NU AAC+ 35% K0884RR IC K0884UE IC K0885NU AAC+ 35% K0885RR IC K0885UE IC K0886NU AAC+ 35% K0886RR IC K0886UE IC K0890NU AAC+ 35% K0890RR IC K0890UE IC K0891NU AAC+ 35% K0891RR IC K0891UE IC K0898NU AAC+ 35% K0898RR IC K0898UE IC K0899NU AAC+ 35% K0899RR IC K0899UE IC K0900 AAC+ 30% K1027 AAC+ 30%

135

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) K1035 AAC+ 30% K1036 AAC+ 30% K1037 AAC+ 30% L8501 $160.46 Q0155 IC Q0161 AAC Q0162 $0.01 Q0163 $0.22 Q0164 AAC+ 20% Q0166 AAC+ 20% Q0167 $2.28 Q0169 $0.03 Q0173 $0.30 Q0174 AAC Q0175 $1.72 Q0177 $0.12 Q0180 $94.79 Q0510 $42.50 Q0511 $20.40 Q0512 $13.60 Q0513 $28.05 Q0514 $56.10 Q0521 IC Q2052 AAC Q2055 $427,936.35 Q4074 $125.09 Q5101 $0.82 Q5135 IC Q5136 IC Q5137 IC Q5138 IC Q5140 IC Q5141 IC Q5142 IC Q5143 IC Q5144 IC

136

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) Q5145 IC Q5146 IC Q5147 $676.48 Q5148 IC Q5149 IC Q5150 IC Q5151 IC Q5152 IC S5035 IC S5036 IC S5160 $38.53 S5160U8 $38.53 S5161RR $20.00 S5161RRU8 $20.00 S5162 AAC+ 30% S5162TW $30.00 S5162TWU8 $30.00 S5162U8 AAC+ 30% S5497 $13.95 S5498 $13.95 S5501 $13.95 S5502 $13.95 S5517 $13.95 S5518 $13.95 S5520 $125.83 S5521 $120.79 S5522SD $86.99 S5523SD $86.99 S8097 AAC+ 20% S8186 AAC+ 20% S8189 AAC+ 20% S8210 AAC+ 20% S8262 AAC+ 30% S8265 AAC+ 20% S8420 AAC+ 20% S8421 AAC+ 20%

137

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101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) S8422 AAC+ 20% S8423 AAC+ 20% S8424 AAC+ 20% S8425 AAC+ 20% S8426 AAC+ 20% S8427 AAC+ 20% S8428 AAC+ 20% S8429 AAC+ 20% S8430 AAC+ 20% S8431 AAC+ 20% S8450 AAC+ 20% S8451 AAC+ 20% S8452 AAC+ 20% S8490 AAC+ 20% S8999 AAC+ 20% S9325 $37.51 S9326 $37.51 S9327 $37.51 S9328 $37.51 S9329 $46.68 S9330 $46.68 S9331 $46.68 S9336 $44.86 S9338 $51.51 S9339 $35.58 S9340 $14.84 S9341 $12.28 S9342 $14.84 S9343 $12.28 S9345 $51.51 S9346 $44.86 S9347 $44.86 S9348 $73.22 S9349 $44.86 S9351 $44.86 S9353 $44.86

138

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) S9355 $73.22 S9357 $73.22 S9359 $73.22 S9361 $73.22 S9363 $73.22 S9364 $43.95 S9365 $43.95 S9366 $43.95 S9367 $43.95 S9368 $43.95 S9370 $9.62 S9372 $9.62 S9373 $30.04 S9374 $30.04 S9375 $30.04 S9376 $30.04 S9377 $30.04 S9379 AAC+20%+$8.00 S9434 AAC+ 20% S9435 AAC+ 20% S9490 $44.86 S9494 $44.86 S9497 $51.51 S9500 $44.86 S9501 $51.73 S9502 $56.20 S9503 $61.87 S9504 $73.22 S9537 $9.62 S9538 $51.51 S9542 $9.62 S9558 $9.62 S9559 $9.62 S9560 $9.62 S9562 $9.62 S9590 $23.55

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Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

Description (see the DME code spreadsheet at https://www.mass.gov/regulations/101- Code Rate CMR32200-rates-for-durable-medical-equipment- oxygen-and-respiratory-therapy-equipment-) T4521 $0.77 T4522 $0.65 T4522U6 $0.65 T4523 $0.72 T4523U6 $0.87 T4524 $0.86 T4524U6 $1.04 T4525 $0.71 T4526 $0.54 T4527 $0.60 T4528 $0.77 T4529 $0.31 T4530 $0.59 T4531 $0.67 T4532 $0.80 T4533 $0.67 T4534 $0.82 T4535 $0.29 T4535UD $0.79 T4536 $2.28 T4537 $7.42 T4538 AAC+ 20% T4539 $31.73 T4540 $6.82 T4541 $0.26 T4542 $0.19 T4543 $1.29 T4543UD $2.28 T4544 $1.41 T5001NU AAC+ 35% T5001RR IC T5001UE IC

322.07: Severability

140

Final Adoption Date Appears in Mass. Register: February 27, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

.00: RATES FOR DURABLE MEDICAL EQUIPMENT, OXYGEN AND RESPIRATORY THERAPY EQUIPMENT

The provisions of .00 are severable. If any provision of .00 or the application of any provision to the sale or rental of durable medical equipment, medical/surgical supplies, or oxygen and respiratory therapy equipment should be held invalid or unconstitutional, such determination will not be construed to affect the validity or constitutionality of any other provision of .00 or the application of any other provision.

REGULATORY AUTHORITY

.00: M.G.L. c. 118E.

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