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Supported payers & jurisdictions
Payers
AffirmDME supports Medicare Fee-for-Service DME claims today — the world of the DME MACs, LCDs, and ADRs that the checklist engine models. Medicare Advantage and commercial payers run their own PA processes and aren’t yet supported.
Jurisdictions and MACs
Medicare divides DME processing into four jurisdictions, each run by a MAC:
| Jurisdiction | MAC |
|---|---|
| A (Northeast) | Noridian |
| B (Midwest) | CGS |
| C (South) | CGS |
| D (West) | Noridian |
Your location carries its jurisdiction and MAC, and cases inherit them — which matters because checklist rules can be jurisdiction- or MAC-specific, and AffirmDME scopes the checklist to your case’s routing automatically.
Equipment coverage depth
The universal documentation rules apply to every case regardless of equipment. On top of that, equipment-specific rule sets currently cover CPAP (E0601), BiPAP/RAD (E0470), oxygen (E1390), hospital beds (E0260), and mobility devices (E1161) — with more categories added over time. A case for an uncovered HCPCS still gets the full universal checklist.