MyMedi-AI

E0602 — Breast pump, manual, any type

HCPCS Level II E-code · short descriptor: “Manual breast pump”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Inexpensive or routinely purchased
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.

E0602 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $42.06 to $50.46 depending on state and rural status.

Former-CBA payment limits: ceiling $42.06 · floor $35.75

StateNon-ruralRural
AK$42.06—
AL$42.06—
AR$42.06—
AZ$42.06—
CA$42.06—
CO$42.06—
CT$42.06—
DC$42.06—
DE$42.06—
FL$42.06—
GA$42.06—
HI$42.06—
IA$42.06—
ID$42.06—
IL$42.06—
IN$42.06—
KS$42.06—
KY$42.06—
LA$42.06—
MA$42.06—
MD$42.06—
ME$42.06—
MI$42.06—
MN$42.06—
MO$42.06—
MS$42.06—
MT$42.06—
NC$42.06—
ND$42.06—
NE$42.06—
NH$42.06—
NJ$42.06—
NM$42.06—
NV$42.06—
NY$42.06—
OH$42.06—
OK$42.06—
OR$42.06—
PA$42.06—
PR$50.46—
RI$42.06—
SC$42.06—
SD$42.06—
TN$42.06—
TX$42.06—
UT$42.06—
VA$42.06—
VI$42.06—
VT$42.06—
WA$42.06—
WI$42.06—
WV$42.06—
WY$42.06—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $4.24 to $5.05 depending on state and rural status.

Former-CBA payment limits: ceiling $4.24 · floor $3.60

StateNon-ruralRural
AK$4.24—
AL$4.24—
AR$4.24—
AZ$4.24—
CA$4.24—
CO$4.24—
CT$4.24—
DC$4.24—
DE$4.24—
FL$4.24—
GA$4.24—
HI$4.24—
IA$4.24—
ID$4.24—
IL$4.24—
IN$4.24—
KS$4.24—
KY$4.24—
LA$4.24—
MA$4.24—
MD$4.24—
ME$4.24—
MI$4.24—
MN$4.24—
MO$4.24—
MS$4.24—
MT$4.24—
NC$4.24—
ND$4.24—
NE$4.24—
NH$4.24—
NJ$4.24—
NM$4.24—
NV$4.24—
NY$4.24—
OH$4.24—
OK$4.24—
OR$4.24—
PA$4.24—
PR$5.05—
RI$4.24—
SC$4.24—
SD$4.24—
TN$4.24—
TX$4.24—
UT$4.24—
VA$4.24—
VI$4.24—
VT$4.24—
WA$4.24—
WI$4.24—
WV$4.24—
WY$4.24—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $31.56 to $37.88 depending on state and rural status.

Former-CBA payment limits: ceiling $31.56 · floor $26.83

StateNon-ruralRural
AK$31.56—
AL$31.56—
AR$31.56—
AZ$31.56—
CA$31.56—
CO$31.56—
CT$31.56—
DC$31.56—
DE$31.56—
FL$31.56—
GA$31.56—
HI$31.56—
IA$31.56—
ID$31.56—
IL$31.56—
IN$31.56—
KS$31.56—
KY$31.56—
LA$31.56—
MA$31.56—
MD$31.56—
ME$31.56—
MI$31.56—
MN$31.56—
MO$31.56—
MS$31.56—
MT$31.56—
NC$31.56—
ND$31.56—
NE$31.56—
NH$31.56—
NJ$31.56—
NM$31.56—
NV$31.56—
NY$31.56—
OH$31.56—
OK$31.56—
OR$31.56—
PA$31.56—
PR$37.88—
RI$31.56—
SC$31.56—
SD$31.56—
TN$31.56—
TX$31.56—
UT$31.56—
VA$31.56—
VI$31.56—
VT$31.56—
WA$31.56—
WI$31.56—
WV$31.56—
WY$31.56—
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 E0602 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E0600E0601E0603E0604E0605E0606E0607E0610E0615E0616E0617E0618

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