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Modifier BP

Beneficiary Elects to Purchase DME

Modifier BP identifies when a Medicare beneficiary has been informed of the purchase and rental options for certain durable medical equipment and elects to purchase the item.

On This Page

Related Modifiers

Modifier RR

Rental Equipment

Modifier RB

Replacement Parts

Modifier RA

Equipment Replacement

When to Use

When NOT to Use

BP vs. BR & BU

Billing Example

Beneficiary Rules

Documentation

Billing Errors

FAQs

What Is Modifier BP?

Modifier BP is a HCPCS Level II modifier used to identify a beneficiary's decision to purchase durable medical equipment (DME) after being informed of the available purchase and rental options.

Its official descriptor is “The beneficiary has been informed of the purchase and rental options and has elected to purchase the item.”

Modifier BP is associated with certain DME payment arrangements, particularly equipment classified as inexpensive or routinely purchased under applicable Medicare rules.

The modifier communicates the beneficiary's purchase election. It does not identify the equipment's condition, establish medical necessity, or independently guarantee reimbursement.

Important: Modifier BP is not required for every DME purchase. Its use depends on the equipment's payment category and the payer's billing instructions.

Quick Reference

Modifier: BP

Type: Beneficiary Election

Category: DMEPOS

Meaning: Purchase Election

Billing: Purchase

Notice: Purchase/Rental Options

When to Use Modifier BP

Beneficiary Elects Purchase

Report BP when a beneficiary has been informed of the available purchase and rental options and chooses to purchase eligible durable medical equipment.

Eligible Equipment Category

Use BP with DME items for which the applicable payer requires a beneficiary purchase election modifier.

Purchase Option Explained

Confirm that the beneficiary received information about the available purchase and rental arrangements before making the election.

Documented Beneficiary Decision

Maintain records establishing that the beneficiary selected the purchase option.

Applicable Payer Requirements

Follow Medicare or other payer instructions regarding eligible equipment, purchase elections, and required modifier reporting.

Important: A supplier's decision to bill equipment as a purchase does not establish that the beneficiary made a valid purchase election.

When NOT to Use Modifier BP

Beneficiary Chooses Rental

Do not report BP when the beneficiary elects to rent the equipment. Modifier BR may be appropriate when the payer requires a rental election modifier.

No Election Documented

Do not use BP when the beneficiary has not made a documented purchase election.

Purchase and Rental Options Not Explained

Do not report BP when required beneficiary notification has not occurred.

Equipment Not Eligible for Election

Do not append BP to DME items that do not qualify for the applicable purchase/rental election arrangement.

Supplier-Selected Purchase

Do not use BP solely because the supplier prefers to furnish the equipment as a purchase.

Equipment Condition Only

BP does not identify whether equipment is new or used. Modifiers NU and UE address equipment condition when applicable.

Important: BP represents the beneficiary's informed purchase election, not simply the fact that an item was purchased.

Modifier BP vs. BR and BU

These three modifiers distinguish the beneficiary's decision regarding eligible DME purchase and rental options.

Modifier BP – Purchase Election

The beneficiary has been informed of the available purchase and rental options and elects to purchase the equipment.

Modifier BR – Rental Election

The beneficiary has been informed of the available purchase and rental options and elects to rent the equipment.

Modifier BU – No Election After 30 Days

The beneficiary has been informed of the available options but has not made a decision after 30 days.

Key Difference: BP identifies a purchase election, BR identifies a rental election, and BU identifies the absence of an election after the applicable 30-day period.

Important Billing Rule: These modifiers are not interchangeable. The modifier must reflect the beneficiary's actual election status and the applicable equipment payment policy.

Billing Example

A Medicare beneficiary requires a manual wheelchair for home use. The supplier determines that the wheelchair falls within an equipment category that permits a purchase or rental election.

After explaining the available options, the beneficiary chooses to purchase the wheelchair. The supplier documents the election and confirms that the equipment meets applicable coverage requirements.

Example – Manual Wheelchair Purchase:

K0001-NU-BP

Claim Details:

HCPCS Code: K0001 – Standard manual wheelchair

Modifier NU: New Equipment

Modifier BP: Beneficiary Elects Purchase

Transaction: Equipment Purchase

Documentation: Beneficiary Election Record

Medical Necessity: Required

Important: This example is illustrative. Modifier BP should be reported with K0001 only when the applicable payer and equipment payment category require or permit a purchase election. The claim must also satisfy coverage and documentation requirements.

Beneficiary Purchase Election Rules

Modifier BP requires particular attention to beneficiary notification, election documentation, and the equipment's payment category.

Purchase and Rental Notification

The beneficiary must be informed of the available purchase and rental options when required by the applicable equipment payment policy.

Beneficiary Choice

The election must reflect the beneficiary's decision rather than a purchase arrangement selected solely by the supplier.

30-Day Election Period

For equipment subject to the BP, BR, and BU election framework, Modifier BU identifies a beneficiary who has not made an election after the applicable 30-day period.

Modifier BP should be reported when the beneficiary has affirmatively elected purchase, rather than merely allowing the election period to expire.

Documentation Requirements

Modifier BP claims should be supported by documentation demonstrating that the beneficiary was informed of the available purchase and rental options and elected to purchase the equipment.

Equipment Order

Maintain a valid order identifying the prescribed DME item.

Medical Necessity

Document the beneficiary's medical condition and need for the equipment.

Beneficiary Notification

Retain records showing that the applicable purchase and rental options were explained.

Purchase Election

Document the beneficiary's decision to purchase, including the election date.

Proof of Delivery

Maintain documentation establishing that the equipment was furnished to the beneficiary.

Documentation Checklist

Valid equipment order retained
Medical necessity supported
Purchase and rental options explained
Beneficiary purchase election documented
Equipment eligibility verified
Proof of delivery retained

Important: Documentation must support the beneficiary's actual election and the applicable payer requirements. A purchase invoice alone does not establish that the beneficiary was informed of both options.

Common Billing Errors and Denials

Modifier BP claims may be denied when the beneficiary's purchase election, equipment eligibility, or supporting documentation does not satisfy payer requirements.

Missing Beneficiary Election

Reporting BP without documentation establishing that the beneficiary elected to purchase the equipment.

Purchase and Rental Options Not Explained

Failing to provide required information about the available equipment purchase and rental arrangements.

Incorrect Election Modifier

Using BP when the beneficiary elected rental or did not make an election within the applicable period.

Ineligible Equipment Category

Appending BP to equipment that does not qualify for the applicable purchase election arrangement.

Unsupported Medical Necessity

Submitting a purchase claim without sufficient documentation supporting the equipment's medical necessity.

Duplicate Rental and Purchase Billing

Submitting purchase and rental claims that result in overlapping or otherwise impermissible reimbursement.

Understanding Purchase Election Denials

When a Modifier BP claim is denied, review the Claim Adjustment Reason Code (CARC) and any associated Remittance Advice Remark Codes (RARCs) on the remittance advice.

For example, CO-16 indicates that a claim or service lacks information or contains submission errors needed for adjudication. Depending on the accompanying remark codes, this may direct the supplier to review missing or incorrect claim information.

For explanations of denial codes and guidance on resolving medical billing denials, visit DenialCodeLookup.com.

Important: Review the beneficiary's election documentation, equipment payment category, and payer billing instructions before correcting or appealing the claim.

Frequently Asked Questions

Can a beneficiary change their decision after electing to purchase DME?

A beneficiary may request a change, but whether the election can be modified depends on the equipment category, transaction status, and payer requirements. Suppliers should verify the applicable policy before changing a previously submitted purchase claim.

Does Modifier BP mean the beneficiary must pay the full purchase price?

No. Modifier BP identifies the beneficiary's purchase election, not the amount the beneficiary must pay. Coverage, deductible, coinsurance, and other financial responsibilities depend on the insurance plan and applicable payment rules.