MyMedi-AI

E0466 — Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)

HCPCS Level II E-code · short descriptor: “Home vent non-invasive inter”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Frequently serviced
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Required from 2026-10-28 (Home ventilators)
MUE unit limit
2
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 2026-10-25; 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 FROM 2026-10-28 E0466 joins Medicare's Required Face-to-Face & WOPD List for dates of service on or after 2026-10-28 (Home ventilators — CMS-6109-N, 91 FR 47972 (published 2026-07-30)). From that date 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.

E0466 Medicare fee schedule (October 2026)

RR — Monthly rental Frequently serviced

Medicare allowable ranges from $1113.72 to $2261.71 depending on state and rural status.

Former-CBA payment limits: ceiling $1360.33 · floor $1156.28

StateNon-ruralRural
AK$1113.72—
AL$1156.28—
AR$1327.91—
AZ$1360.33—
CA$1156.28—
CO$1156.28—
CT$1360.33—
DC$1224.88—
DE$1360.33—
FL$1360.33—
GA$1360.33—
HI$1190.93—
IA$1291.69—
ID$1166.61—
IL$1360.33—
IN$1156.28—
KS$1309.75—
KY$1360.33—
LA$1192.96—
MA$1360.33—
MD$1156.28—
ME$1265.07—
MI$1360.33—
MN$1360.33—
MO$1268.08—
MS$1156.28—
MT$1188.26—
NC$1360.33—
ND$1360.33—
NE$1314.68—
NH$1360.33—
NJ$1360.33—
NM$1311.33—
NV$1360.33—
NY$1360.33—
OH$1360.33—
OK$1360.33—
OR$1333.16—
PA$1360.33—
PR$2261.71—
RI$1360.33—
SC$1156.28—
SD$1360.33—
TN$1360.33—
TX$1360.33—
UT$1249.23—
VA$1358.87—
VI$1360.33—
VT$1193.68—
WA$1156.28—
WI$1164.25—
WV$1360.33—
WY$1360.33—
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 E0466 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Nature of Equipment.

Common denial codes to watch

Related E-codes

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