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M93 Remark Code: Break in Therapy, New Rental Period

M93 means the payer accepted that there was a break in therapy for this capped rental equipment, so a new capped rental period began with the delivery of this item. Rental month counts restart from this delivery.

Quick facts

Code
M93 (RARC M93)
Status
Active In use since January 1, 1997.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Any contractual adjustment on the rental line follows the fee schedule. M93 itself confirms the new rental period.
  • PR (Patient Responsibility): Patient deductible and coinsurance apply to rental months in the new period as usual.
Official description
Information supplied supports a break in therapy. A new capped rental period began with delivery of this equipment.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What M93 means

Many types of durable medical equipment are paid as capped rentals: the payer pays monthly rental up to a limit, after which payment stops or ownership transfers. If the patient stops using the equipment and later needs it again, the question becomes whether the new use continues the old rental period or starts a new one. That depends on whether the payer accepts a break in therapy.

M93 is the favourable outcome. The information you supplied supported a break, so a new capped rental period started with this delivery. The previous months no longer count toward the cap for this new period.

When you see it

  • A patient returned to the same type of equipment after a gap in medical need.
  • You documented the gap and the new need, often with a break-in-need modifier or narrative the payer requires.
  • The payer’s history showed a prior rental for the same or similar item.

What to do

  1. Confirm the line paid as month one of the new rental.
  2. Reset your rental counter for this patient and item so future claims report the right rental month and modifiers.
  3. File the supporting records (new order, documentation of medical need, and evidence of the break) in case of later review.
  4. Watch subsequent months to be sure the payer continues to treat the rental as new.

How to prevent later problems

  • Keep a rental history per patient per item class that includes pickup and delivery dates.
  • Document the reason for the gap and the new need at the time of the new order.
  • Use an ERA Analyzer to catch rental months that start paying differently than expected.

Codes that may appear with M93

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The rental charge was reduced to the fee schedule for the first month of the new period.
  • PR-2 (Coinsurance Amount): Patient coinsurance applied to the rental payment.
  • M94 (Information supplied does not support a break in therapy.): The opposite result: the break in therapy was not supported and no new rental period begins.
  • M103 (Information supplied supports a break in therapy.): A break in therapy was accepted, but the item was paid at a reduced level because the medical need for the item as billed was not supported.
  • M5 (Monthly rental payments can continue until the earlier of the 15th month from the first rental month, or the month when the equipment is no longer…): Explains how long monthly rental payments can continue in a capped rental period.

M93 FAQ

What is a break in therapy?

A period when the patient stopped needing the equipment long enough that a new medical need later starts a new rental period. Medicare and other payers set specific rules for how long the break must be.

Does M93 require any action?

Mainly updating your rental tracking so the month count restarts. Confirm the claim paid as the first month of a new rental.

Do I need new documentation?

A new rental period generally requires current documentation of medical need, such as a new order. Keep it on file.