MyMedi-AI

E0856 — Cervical traction device, with inflatable air bladder(s)

HCPCS Level II E-code · short descriptor: “Cervic collar w air bladders”

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.

E0856 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $21.93 to $26.36 depending on state and rural status.

Former-CBA payment limits: ceiling $21.93 · floor $18.64

StateNon-ruralRural
AK$21.93—
AL$21.93—
AR$21.93—
AZ$21.93—
CA$21.93—
CO$21.93—
CT$21.93—
DC$21.93—
DE$21.93—
FL$21.93—
GA$21.93—
HI$21.93—
IA$21.93—
ID$21.93—
IL$21.93—
IN$21.93—
KS$21.93—
KY$21.93—
LA$21.93—
MA$21.93—
MD$21.93—
ME$21.93—
MI$21.93—
MN$21.93—
MO$21.93—
MS$21.93—
MT$21.93—
NC$21.93—
ND$21.93—
NE$21.93—
NH$21.93—
NJ$21.93—
NM$21.93—
NV$21.93—
NY$21.93—
OH$21.93—
OK$21.93—
OR$21.93—
PA$21.93—
PR$26.36—
RI$21.93—
SC$21.93—
SD$21.93—
TN$21.93—
TX$21.93—
UT$21.93—
VA$21.93—
VI$21.93—
VT$21.93—
WA$21.93—
WI$21.93—
WV$21.93—
WY$21.93—
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 E0856 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 E0856 with confidence

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