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E0471 — Respiratory assist device, bi-level pressure capability, with back-up 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/backup non inv intrfc”

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
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.

E0471 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $324.35 to $642.07 depending on state and rural status.

StateNon-ruralRural
AK$589.44
AL$329.87$520.32
AR$329.87$520.32
AZ$324.35$579.71
CA$329.72$579.71
CO$347.40$529.99
CT$336.67$579.71
DC$325.75$520.32
DE$325.75$520.32
FL$329.87$520.32
GA$329.87$579.71
HI$617.57
IA$337.54$520.32
ID$347.40$579.71
IL$344.03$559.02
IN$344.03$520.32
KS$337.54$579.71
KY$329.87$579.71
LA$329.87$520.32
MA$336.67$579.71
MD$325.75$579.71
ME$336.67$579.71
MI$344.03$579.71
MN$337.54$536.89
MO$337.54$579.71
MS$329.87$540.55
MT$347.40$520.32
NC$329.87$579.71
ND$337.54$520.32
NE$337.54$579.71
NH$336.67$579.71
NJ$325.75$520.32
NM$324.35$520.32
NV$329.72$579.71
NY$325.75$579.71
OH$344.03$579.71
OK$324.35$520.32
OR$329.72$579.71
PA$325.75$520.32
PR$642.07
RI$336.67$579.71
SC$329.87$579.71
SD$337.54$520.32
TN$329.87$579.71
TX$324.35$520.32
UT$347.40$520.32
VA$329.87$548.36
VI$578.13
VT$336.67$579.71
WA$329.72$579.71
WI$344.03$520.32
WV$329.87$579.71
WY$347.40$520.32
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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