NU, UE and RR are three of the most common modifiers on durable medical equipment (DME) claims, and they are easy to mix up. NU and UE describe a purchase; RR describes a rental. Which one applies depends on the item, its Medicare payment category and whether the equipment was new when delivered. This guide explains what each one means and where the choice goes wrong.
Last reviewed: October 2026. Sources are listed at the end. DME MAC pages are updated regularly, so confirm against your jurisdiction’s current guidance.
What NU, UE and RR mean
| Modifier | Descriptor | In plain terms |
|---|---|---|
| NU | New durable medical equipment purchase | The patient is buying equipment that was new when delivered |
| UE | Used durable medical equipment purchase | The patient is buying equipment that has been owned or rented before |
| RR | Rental (use when DME is to be rented) | The item is being rented |
Key point: NU and RR are what Noridian calls pricing modifiers, along with KH, KI and KJ. They go in the first modifier position on the claim line.
Which payment category the item falls into
NU and UE are appended to purchases of new or used items in the Inexpensive or Routinely Purchased (IRP) category. In Medicare’s payment rules, “inexpensive” means a purchase price that does not exceed $150, and “routinely purchased” means the item was bought at least 75 percent of the time, using the historical data periods set in the regulation (42 CFR 414.220). IRP items can be rented or bought, and the total payment cannot exceed the actual charge or the purchase fee.
RR is broader. It is used for IRP rentals and also for capped rental items, items that require frequent and substantial servicing, and oxygen equipment. For capped rental, RR is reported together with the KH, KI or KJ month modifier; see our rental vs. purchase billing guide for the month-by-month pattern.
What counts as “new” and “used”
NU should be used only if new equipment was actually delivered. Used equipment means equipment that was previously purchased or rented by someone else, and that includes items used for a trial period and demonstrator items, even when no commercial transaction took place.
What happens if you leave it off
If an assigned claim does not indicate whether the equipment was new or used, the DME MAC treats it as used and pays the used purchase fee. Also note that the KH modifier was removed from NU and UE purchase claims effective October 1, 2018 (CMS Transmittal 4052), so older examples that show KH alongside NU are out of date.
Tip: make “new or used?” a required field in your delivery or intake workflow, so the modifier is never chosen from memory at billing time.
Buying an item after renting it
For inexpensive items that were rented first and then purchased, the purchase claim carries UE. Under the CMS Claims Processing Manual, the allowed amount is the lower of the purchase fee minus prior rental payments or the supplier’s actual charge. Check the current manual section and your MAC’s guidance before relying on this for a specific item.
A special case: complex rehabilitative power wheelchairs
For complex rehabilitative power wheelchairs and accessories, Noridian’s capped rental guidance calls for NU (or UE) along with KH and the BP modifier. This is an exception to the general rule that KH is not used on purchase claims, so follow the item-specific instructions.
Documentation to keep
Supplier Standard 5 requires telling the beneficiary that they may rent or purchase IRP items, and about the purchase option on capped rental items. Many suppliers record this on the proof of delivery. Standard documentation, including the written order, proof of delivery and evidence of continued use and need, is set out in the relevant policy article for each product.
Places the choice goes wrong
- NU billed for equipment that was not new, or not yet delivered.
- UE used on a first-owner new item.
- A purchase modifier used on an item that is rental-only, such as equipment in the frequent-and-substantial-servicing category or oxygen equipment.
- RR used without the matching month modifier on a capped rental item.
- An unlabeled purchase claim that defaults to the used fee.
These are logical checks drawn from the modifier definitions, not published error rates; we did not find an authoritative source that ranks the most common denials for these modifiers.
Related guides
- DME Billing Modifiers: NU, RR, KX, GA/GZ, KH/KI/KJ Guide
- DME Rental vs. Purchase Billing: RR, NU, UE, KH, KI, KJ
- KX Modifier Explained: When to Use It and When Not To
- Free Modifier and Place of Service reference tool
Sources
- Noridian JD DME modifiers (updated April 2026): noridianmedicare.com
- Noridian, Inexpensive or Routinely Purchased payment category: noridianmedicare.com
- Noridian, UE modifier: noridianmedicare.com
- Noridian, capped rental payment category: noridianmedicare.com
- 42 CFR 414.220: ecfr.gov
- CMS Transmittal 4052 (May 2018): cms.gov
- CMS Claims Processing Manual, Chapter 20: cms.gov
This article is educational and is not legal or coding advice. Always confirm current rules with your DME MAC and the official CMS manuals.