MyMedi-AI

E1700 — Jaw motion rehabilitation system

HCPCS Level II E-code · short descriptor: “Jaw motion rehab system”

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.

E1700 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $41.78 to $62.34 depending on state and rural status.

Former-CBA payment limits: ceiling $49.15 · floor $41.78

StateNon-ruralRural
AK$55.34—
AL$49.15—
AR$41.78—
AZ$49.15—
CA$49.15—
CO$46.30—
CT$49.15—
DC$41.78—
DE$41.78—
FL$49.15—
GA$49.15—
HI$59.13—
IA$48.20—
ID$49.15—
IL$49.15—
IN$41.78—
KS$49.15—
KY$49.15—
LA$41.78—
MA$44.49—
MD$49.15—
ME$44.49—
MI$41.78—
MN$49.15—
MO$49.15—
MS$49.15—
MT$41.78—
NC$49.15—
ND$49.15—
NE$49.15—
NH$44.49—
NJ$41.78—
NM$49.15—
NV$49.15—
NY$49.15—
OH$41.78—
OK$49.15—
OR$49.15—
PA$41.78—
PR$62.34—
RI$44.49—
SC$46.30—
SD$49.15—
TN$49.15—
TX$41.78—
UT$41.78—
VA$41.78—
VI$49.15—
VT$44.49—
WA$41.78—
WI$41.78—
WV$41.78—
WY$49.15—
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 E1700 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 E1700 with confidence

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