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M9 Remark Code: Tenth Rental Month Purchase Option

M9 is an alert that the equipment has reached its tenth rental month. The supplier must offer the patient the option of switching from rental to a purchase agreement.

Quick facts

Code
M9 (RARC M9)
Status
Active In use since January 1, 1997; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Any adjustment on the line is the supplier's contractual responsibility. M9 itself signals a required patient notice, not a denial.
Official description
Alert: This is the tenth rental month. You must offer the patient the choice of changing the rental to a purchase agreement.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What M9 means

M9 is a timing alert for capped rental durable medical equipment. The payer is telling the supplier that the tenth rental month has been reached and that the patient must now be given a choice: keep renting or convert the rental into a purchase. It rides along with a normal rental payment and does not change the amount paid on its own.

This is a Medicare-style remark. Payers that still use a purchase option structure for certain items may apply it.

What to do

  1. Contact the patient and explain the rent or purchase options in plain language.
  2. Record the patient’s decision in writing and keep it in the equipment file.
  3. Update your billing so the next claim reflects the chosen option.
  4. Watch for M36 on the following month. If it appears, the payer is waiting for proof the option was offered.

No appeal or corrected claim is needed for M9 alone. It is a prompt to act before the next rental claim goes out, not a problem with this one.

Codes that may appear with M9

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The rental payment was reduced to the fee schedule amount as usual.
  • PR-2 (Coinsurance Amount): Patient coinsurance applied to the rental month.
  • M36 (This is the 11th rental month.): The follow-up: the eleventh rental month cannot be paid until you show the purchase option was offered.
  • M10 (Equipment purchases are limited to the first or the tenth month of medical necessity.): Equipment purchases are limited to the first or tenth month of medical necessity.
  • N160 (The patient must choose an option before a payment can be made for this procedure/ equipment/ supply/ service.): The patient must choose an option before payment can be made.

M9 FAQ

Is the tenth-month purchase option still required?

The remark reflects a purchase option rule used for certain capped rental items. Current Medicare rules have changed over time, so confirm what applies to the item category and date of service.

What happens if I do not offer the option?

The payer may withhold the next rental payment, as described by M36, until you confirm the patient was given the choice.

Should the patient's choice be documented?

Yes. Keep the patient's written election in the record so you can show it if the payer asks.