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RA Modifier Pricing Update

February 1, 2024

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.