MyMedi-AI

E0431 — Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing

HCPCS Level II E-code · short descriptor: “Portable gaseous 02”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Oxygen & oxygen equipment
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Required (Oxygen equipment)
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-26; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

F2F + WOPD REQUIRED E0431 is on Medicare's Required Face-to-Face & WOPD List (Oxygen equipment — CMS Required F2F & WOPD List — 83 items in force on 2026-10-26; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). Two extra conditions of payment apply:

  • Face-to-face encounter (in-person or telehealth) with the treating practitioner within the 6 months before the order date
  • Written order communicated to the supplier before delivery (WOPD)

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

E0431 Medicare fee schedule (October 2026)

RR — Monthly rental Oxygen & oxygen equipment

Medicare allowable ranges from $21.24 to $31.64 depending on state and rural status.

StateNon-ruralRural
AK$31.64—
AL$22.14$31.64
AR$22.14$31.64
AZ$22.11$31.64
CA$21.88$31.64
CO$22.93$31.64
CT$22.09$31.64
DC$21.24$31.64
DE$21.24$31.64
FL$22.14$31.64
GA$22.14$31.64
HI$31.64—
IA$22.66$31.64
ID$22.93$31.64
IL$22.12$31.64
IN$22.12$31.64
KS$22.66$31.64
KY$22.14$31.64
LA$22.14$31.64
MA$22.09$31.64
MD$21.24$31.64
ME$22.09$31.64
MI$22.12$31.64
MN$22.66$31.64
MO$22.66$31.64
MS$22.14$31.64
MT$22.93$31.64
NC$22.14$31.64
ND$22.66$31.64
NE$22.66$31.64
NH$22.09$31.64
NJ$21.24$31.64
NM$22.11$31.64
NV$21.88$31.64
NY$21.24$31.64
OH$22.12$31.64
OK$22.11$31.64
OR$21.88$31.64
PA$21.24$31.64
PR$31.64—
RI$22.09$31.64
SC$22.14$31.64
SD$22.66$31.64
TN$22.14$31.64
TX$22.11$31.64
UT$22.93$31.64
VA$22.14$31.64
VI$31.64—
VT$22.09$31.64
WA$21.88$31.64
WI$22.12$31.64
WV$22.14$31.64
WY$22.93$31.64

RR + QB — Monthly rental Oxygen & oxygen equipment

Medicare allowable ranges from $47.28 to $88.58 depending on state and rural status.

StateNon-ruralRural
AK$88.58—
AL$50.11$88.58
AR$50.11$88.58
AZ$49.08$88.58
CA$47.28$88.58
CO$50.56$88.58
CT$49.77$88.58
DC$48.20$88.58
DE$48.20$88.58
FL$50.11$88.58
GA$50.11$88.58
HI$88.58—
IA$50.08$88.58
ID$50.56$88.58
IL$49.66$88.58
IN$49.66$88.58
KS$50.08$88.58
KY$50.11$88.58
LA$50.11$88.58
MA$49.77$88.58
MD$48.20$88.58
ME$49.77$88.58
MI$49.66$88.58
MN$50.08$88.58
MO$50.08$88.58
MS$50.11$88.58
MT$50.56$88.58
NC$50.11$88.58
ND$50.08$88.58
NE$50.08$88.58
NH$49.77$88.58
NJ$48.20$88.58
NM$49.08$88.58
NV$47.28$88.58
NY$48.20$88.58
OH$49.66$88.58
OK$49.08$88.58
OR$47.28$88.58
PA$48.20$88.58
PR$88.58—
RI$49.77$88.58
SC$50.11$88.58
SD$50.08$88.58
TN$50.11$88.58
TX$49.08$88.58
UT$50.56$88.58
VA$50.11$88.58
VI$88.58—
VT$49.77$88.58
WA$47.28$88.58
WI$49.66$88.58
WV$50.11$88.58
WY$50.56$88.58

RR + QF — Monthly rental Oxygen & oxygen equipment

Medicare allowable ranges from $47.28 to $88.58 depending on state and rural status.

StateNon-ruralRural
AK$88.58—
AL$50.11$88.58
AR$50.11$88.58
AZ$49.08$88.58
CA$47.28$88.58
CO$50.56$88.58
CT$49.77$88.58
DC$48.20$88.58
DE$48.20$88.58
FL$50.11$88.58
GA$50.11$88.58
HI$88.58—
IA$50.08$88.58
ID$50.56$88.58
IL$49.66$88.58
IN$49.66$88.58
KS$50.08$88.58
KY$50.11$88.58
LA$50.11$88.58
MA$49.77$88.58
MD$48.20$88.58
ME$49.77$88.58
MI$49.66$88.58
MN$50.08$88.58
MO$50.08$88.58
MS$50.11$88.58
MT$50.56$88.58
NC$50.11$88.58
ND$50.08$88.58
NE$50.08$88.58
NH$49.77$88.58
NJ$48.20$88.58
NM$49.08$88.58
NV$47.28$88.58
NY$48.20$88.58
OH$49.66$88.58
OK$49.08$88.58
OR$47.28$88.58
PA$48.20$88.58
PR$88.58—
RI$49.77$88.58
SC$50.11$88.58
SD$50.08$88.58
TN$50.11$88.58
TX$49.08$88.58
UT$50.56$88.58
VA$50.11$88.58
VI$88.58—
VT$49.77$88.58
WA$47.28$88.58
WI$49.66$88.58
WV$50.11$88.58
WY$50.56$88.58
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps E0431 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E0424E0425E0430E0433E0434E0435E0439E0440E0441E0442E0443E0444

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