RA Modifier Pricing Update

Premera is updating its reimbursement of claims that include an RA modifier. RA is used to indicate the replacement of a durable medical equipment (DME), orthotic, or prosthetic item. Effective May 1, 2024, claims that include an RA modifier need to include either the RR or NU modifier to indicate a replacement rental or a replacement purchase:

• RR RA (Replacement Rental- RA only to be appended on the first month rental claim only) – code will price based on the rental amount.

• NU RA (Replacement Purchase- RA must be appended to the claim for a purchase) – code will price based on the purchase amount.

Additional details can be found in the Premera RA modifier payment policy.