MyMedi-AI

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
Face-to-face & WOPD
Not on the required 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.

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))

Not on the F2F/WOPD list (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

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

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.

StateNon-ruralRural
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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