E0468 — Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions
HCPCS Level II E-code · short descriptor: “Home vent dual fnct incl all”
- 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
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
E0468 Medicare fee schedule (April 2026)
RR — Monthly rental Frequently serviced
Medicare allowable ranges from $1229.81 to $2381.50 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $1229.81 | — |
| AL | $1256.30 | — |
| AR | $1430.05 | — |
| AZ | $1455.14 | — |
| CA | $1253.58 | — |
| CO | $1258.42 | — |
| CT | $1462.47 | — |
| DC | $1327.01 | — |
| DE | $1460.04 | — |
| FL | $1453.83 | — |
| GA | $1459.41 | — |
| HI | $1287.05 | — |
| IA | $1393.83 | — |
| ID | $1268.75 | — |
| IL | $1462.47 | — |
| IN | $1258.42 | — |
| KS | $1411.89 | — |
| KY | $1462.47 | — |
| LA | $1293.30 | — |
| MA | $1462.47 | — |
| MD | $1252.62 | — |
| ME | $1367.20 | — |
| MI | $1458.01 | — |
| MN | $1462.47 | — |
| MO | $1370.22 | — |
| MS | $1247.81 | — |
| MT | $1280.37 | — |
| NC | $1462.47 | — |
| ND | $1452.30 | — |
| NE | $1416.82 | — |
| NH | $1462.47 | — |
| NJ | $1456.18 | — |
| NM | $1401.63 | — |
| NV | $1457.43 | — |
| NY | $1459.37 | — |
| OH | $1462.47 | — |
| OK | $1462.47 | — |
| OR | $1435.30 | — |
| PA | $1458.22 | — |
| PR | $2381.50 | — |
| RI | $1447.16 | — |
| SC | $1254.64 | — |
| SD | $1460.51 | — |
| TN | $1456.09 | — |
| TX | $1462.47 | — |
| UT | $1351.38 | — |
| VA | $1455.32 | — |
| VI | $1462.47 | — |
| VT | $1295.81 | — |
| WA | $1258.42 | — |
| WI | $1266.39 | — |
| WV | $1459.02 | — |
| WY | $1460.18 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
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.
Common denial codes to watch
Related E-codes
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