MyMedi-AI

E0779 — Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater

HCPCS Level II E-code · short descriptor: “Amb infusion pump mechanical”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
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.

E0779 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $20.95 to $27.85 depending on state and rural status.

StateNon-ruralRural
AK$27.85—
AL$23.47$23.47
AR$23.83$23.83
AZ$22.24$22.24
CA$22.83$22.83
CO$23.83$23.83
CT$23.83$23.83
DC$23.83$23.83
DE$23.41$23.41
FL$21.93$21.93
GA$23.27$23.27
HI$25.15—
IA$23.83$23.83
ID$23.83$23.83
IL$23.83$23.83
IN$23.83$23.83
KS$23.83$23.83
KY$23.83$23.83
LA$23.55$23.55
MA$23.83$23.83
MD$22.61$22.61
ME$23.83$23.83
MI$22.96$22.96
MN$23.83$23.83
MO$23.83$23.83
MS$21.48$21.48
MT$21.62$21.62
NC$23.83$23.83
ND$21.57$21.57
NE$23.83$23.83
NH$23.83$23.83
NJ$23.83$23.83
NM$21.16$21.16
NV$22.78$22.78
NY$23.27$23.27
OH$23.83$23.83
OK$23.83$23.83
OR$23.83$23.83
PA$22.98$22.98
PR$25.98—
RI$20.95$20.95
SC$23.11$23.11
SD$23.52$23.52
TN$22.49$22.49
TX$23.83$23.83
UT$23.83$23.83
VA$22.64$22.64
VI$23.27—
VT$23.83$23.83
WA$23.83$23.83
WI$23.83$23.83
WV$23.18$23.18
WY$23.43$23.43
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 E0779 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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