E0470 — Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
HCPCS Level II E-code · short descriptor: “Rad w/o backup non-inv intfc”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Capped rental
- Prior authorization
- Not on Medicare required-PA list
- Face-to-face & WOPD
- Not on the required list
- 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 2026-10-25; 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))
Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.
Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.
E0470 Medicare fee schedule (October 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $129.84 to $237.27 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $226.66 | — |
| AL | $133.94 | $219.43 |
| AR | $133.94 | $232.10 |
| AZ | $133.39 | $208.36 |
| CA | $132.96 | $225.75 |
| CO | $136.68 | $232.10 |
| CT | $135.49 | $221.73 |
| DC | $129.84 | $208.36 |
| DE | $129.84 | $208.36 |
| FL | $133.94 | $217.50 |
| GA | $133.94 | $232.10 |
| HI | $237.27 | — |
| IA | $135.67 | $232.10 |
| ID | $136.68 | $232.10 |
| IL | $136.67 | $232.10 |
| IN | $136.67 | $232.10 |
| KS | $135.67 | $232.10 |
| KY | $133.94 | $232.10 |
| LA | $133.94 | $232.10 |
| MA | $135.49 | $216.79 |
| MD | $129.84 | $208.36 |
| ME | $135.49 | $220.97 |
| MI | $136.67 | $208.36 |
| MN | $135.67 | $210.27 |
| MO | $135.67 | $232.10 |
| MS | $133.94 | $217.01 |
| MT | $136.68 | $209.45 |
| NC | $133.94 | $232.10 |
| ND | $135.67 | $232.10 |
| NE | $135.67 | $232.10 |
| NH | $135.49 | $215.58 |
| NJ | $129.84 | $208.36 |
| NM | $133.39 | $225.99 |
| NV | $132.96 | $208.36 |
| NY | $129.84 | $232.10 |
| OH | $136.67 | $232.10 |
| OK | $133.39 | $232.10 |
| OR | $132.96 | $228.84 |
| PA | $129.84 | $208.36 |
| PR | $134.93 | — |
| RI | $135.49 | $220.55 |
| SC | $133.94 | $232.10 |
| SD | $135.67 | $232.10 |
| TN | $133.94 | $232.10 |
| TX | $133.39 | $232.10 |
| UT | $136.68 | $226.71 |
| VA | $133.94 | $232.10 |
| VI | $231.46 | — |
| VT | $135.49 | $216.30 |
| WA | $132.96 | $232.10 |
| WI | $136.67 | $230.87 |
| WV | $133.94 | $232.10 |
| WY | $136.68 | $232.10 |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0470 at 1 unit 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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