E0691 — Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less
HCPCS Level II E-code · short descriptor: “Uvl pnl 2 sq ft or less”
- 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.
E0691 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $1280.61 to $1536.77 depending on state and rural status.
Former-CBA payment limits: ceiling $1280.61 · floor $1088.52
| State | Non-rural | Rural |
|---|---|---|
| AK | $1280.61 | — |
| AL | $1280.61 | — |
| AR | $1280.61 | — |
| AZ | $1280.61 | — |
| CA | $1280.61 | — |
| CO | $1280.61 | — |
| CT | $1280.61 | — |
| DC | $1280.61 | — |
| DE | $1280.61 | — |
| FL | $1280.61 | — |
| GA | $1280.61 | — |
| HI | $1280.61 | — |
| IA | $1280.61 | — |
| ID | $1280.61 | — |
| IL | $1280.61 | — |
| IN | $1280.61 | — |
| KS | $1280.61 | — |
| KY | $1280.61 | — |
| LA | $1280.61 | — |
| MA | $1280.61 | — |
| MD | $1280.61 | — |
| ME | $1280.61 | — |
| MI | $1280.61 | — |
| MN | $1280.61 | — |
| MO | $1280.61 | — |
| MS | $1280.61 | — |
| MT | $1280.61 | — |
| NC | $1280.61 | — |
| ND | $1280.61 | — |
| NE | $1280.61 | — |
| NH | $1280.61 | — |
| NJ | $1280.61 | — |
| NM | $1280.61 | — |
| NV | $1280.61 | — |
| NY | $1280.61 | — |
| OH | $1280.61 | — |
| OK | $1280.61 | — |
| OR | $1280.61 | — |
| PA | $1280.61 | — |
| PR | $1536.77 | — |
| RI | $1280.61 | — |
| SC | $1280.61 | — |
| SD | $1280.61 | — |
| TN | $1280.61 | — |
| TX | $1280.61 | — |
| UT | $1280.61 | — |
| VA | $1280.61 | — |
| VI | $1280.61 | — |
| VT | $1280.61 | — |
| WA | $1280.61 | — |
| WI | $1280.61 | — |
| WV | $1280.61 | — |
| WY | $1280.61 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $128.05 to $153.67 depending on state and rural status.
Former-CBA payment limits: ceiling $128.05 · floor $108.84
| State | Non-rural | Rural |
|---|---|---|
| AK | $128.05 | — |
| AL | $128.05 | — |
| AR | $128.05 | — |
| AZ | $128.05 | — |
| CA | $128.05 | — |
| CO | $128.05 | — |
| CT | $128.05 | — |
| DC | $128.05 | — |
| DE | $128.05 | — |
| FL | $128.05 | — |
| GA | $128.05 | — |
| HI | $128.05 | — |
| IA | $128.05 | — |
| ID | $128.05 | — |
| IL | $128.05 | — |
| IN | $128.05 | — |
| KS | $128.05 | — |
| KY | $128.05 | — |
| LA | $128.05 | — |
| MA | $128.05 | — |
| MD | $128.05 | — |
| ME | $128.05 | — |
| MI | $128.05 | — |
| MN | $128.05 | — |
| MO | $128.05 | — |
| MS | $128.05 | — |
| MT | $128.05 | — |
| NC | $128.05 | — |
| ND | $128.05 | — |
| NE | $128.05 | — |
| NH | $128.05 | — |
| NJ | $128.05 | — |
| NM | $128.05 | — |
| NV | $128.05 | — |
| NY | $128.05 | — |
| OH | $128.05 | — |
| OK | $128.05 | — |
| OR | $128.05 | — |
| PA | $128.05 | — |
| PR | $153.67 | — |
| RI | $128.05 | — |
| SC | $128.05 | — |
| SD | $128.05 | — |
| TN | $128.05 | — |
| TX | $128.05 | — |
| UT | $128.05 | — |
| VA | $128.05 | — |
| VI | $128.05 | — |
| VT | $128.05 | — |
| WA | $128.05 | — |
| WI | $128.05 | — |
| WV | $128.05 | — |
| WY | $128.05 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $960.46 to $1152.57 depending on state and rural status.
Former-CBA payment limits: ceiling $960.46 · floor $816.39
| State | Non-rural | Rural |
|---|---|---|
| AK | $960.46 | — |
| AL | $960.46 | — |
| AR | $960.46 | — |
| AZ | $960.46 | — |
| CA | $960.46 | — |
| CO | $960.46 | — |
| CT | $960.46 | — |
| DC | $960.46 | — |
| DE | $960.46 | — |
| FL | $960.46 | — |
| GA | $960.46 | — |
| HI | $960.46 | — |
| IA | $960.46 | — |
| ID | $960.46 | — |
| IL | $960.46 | — |
| IN | $960.46 | — |
| KS | $960.46 | — |
| KY | $960.46 | — |
| LA | $960.46 | — |
| MA | $960.46 | — |
| MD | $960.46 | — |
| ME | $960.46 | — |
| MI | $960.46 | — |
| MN | $960.46 | — |
| MO | $960.46 | — |
| MS | $960.46 | — |
| MT | $960.46 | — |
| NC | $960.46 | — |
| ND | $960.46 | — |
| NE | $960.46 | — |
| NH | $960.46 | — |
| NJ | $960.46 | — |
| NM | $960.46 | — |
| NV | $960.46 | — |
| NY | $960.46 | — |
| OH | $960.46 | — |
| OK | $960.46 | — |
| OR | $960.46 | — |
| PA | $960.46 | — |
| PR | $1152.57 | — |
| RI | $960.46 | — |
| SC | $960.46 | — |
| SD | $960.46 | — |
| TN | $960.46 | — |
| TX | $960.46 | — |
| UT | $960.46 | — |
| VA | $960.46 | — |
| VI | $960.46 | — |
| VT | $960.46 | — |
| WA | $960.46 | — |
| WI | $960.46 | — |
| WV | $960.46 | — |
| WY | $960.46 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0691 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
Related E-codes
Bill E0691 with confidence
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