E2103 — Non-adjunctive, non-implanted continuous glucose monitor or receiver
HCPCS Level II E-code · short descriptor: “Non-adju cgm receiver/mon”
- 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.
E2103 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $256.09 to $301.27 depending on state and rural status.
Former-CBA payment limits: ceiling $301.27 · floor $256.08
| State | Non-rural | Rural |
|---|---|---|
| AK | $301.27 | — |
| AL | $276.58 | — |
| AR | $298.46 | — |
| AZ | $301.27 | — |
| CA | $301.27 | — |
| CO | $283.55 | — |
| CT | $283.23 | — |
| DC | $277.92 | — |
| DE | $277.43 | — |
| FL | $301.27 | — |
| GA | $283.94 | — |
| HI | $301.27 | — |
| IA | $301.27 | — |
| ID | $292.13 | — |
| IL | $301.27 | — |
| IN | $256.09 | — |
| KS | $301.27 | — |
| KY | $301.27 | — |
| LA | $301.27 | — |
| MA | $276.00 | — |
| MD | $281.61 | — |
| ME | $276.00 | — |
| MI | $301.27 | — |
| MN | $278.48 | — |
| MO | $301.27 | — |
| MS | $301.27 | — |
| MT | $276.18 | — |
| NC | $286.15 | — |
| ND | $301.27 | — |
| NE | $301.27 | — |
| NH | $276.00 | — |
| NJ | $279.44 | — |
| NM | $301.27 | — |
| NV | $301.27 | — |
| NY | $301.27 | — |
| OH | $301.27 | — |
| OK | $301.27 | — |
| OR | $276.45 | — |
| PA | $271.23 | — |
| PR | $301.27 | — |
| RI | $292.93 | — |
| SC | $301.27 | — |
| SD | $301.27 | — |
| TN | $301.27 | — |
| TX | $301.27 | — |
| UT | $301.27 | — |
| VA | $280.94 | — |
| VI | $301.27 | — |
| VT | $276.00 | — |
| WA | $301.27 | — |
| WI | $273.53 | — |
| WV | $301.27 | — |
| WY | $295.95 | — |
NU + KF — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $284.30 to $334.44 depending on state and rural status.
Former-CBA payment limits: ceiling $334.44 · floor $284.27
| State | Non-rural | Rural |
|---|---|---|
| AK | $334.44 | — |
| AL | $307.05 | — |
| AR | $331.38 | — |
| AZ | $334.44 | — |
| CA | $334.44 | — |
| CO | $314.81 | — |
| CT | $314.49 | — |
| DC | $308.52 | — |
| DE | $308.04 | — |
| FL | $334.44 | — |
| GA | $315.21 | — |
| HI | $334.44 | — |
| IA | $334.44 | — |
| ID | $324.32 | — |
| IL | $334.44 | — |
| IN | $284.30 | — |
| KS | $334.44 | — |
| KY | $334.44 | — |
| LA | $334.44 | — |
| MA | $306.44 | — |
| MD | $312.68 | — |
| ME | $306.44 | — |
| MI | $334.44 | — |
| MN | $309.17 | — |
| MO | $334.44 | — |
| MS | $334.44 | — |
| MT | $306.61 | — |
| NC | $317.73 | — |
| ND | $334.44 | — |
| NE | $334.44 | — |
| NH | $306.44 | — |
| NJ | $310.28 | — |
| NM | $334.44 | — |
| NV | $334.44 | — |
| NY | $334.44 | — |
| OH | $334.44 | — |
| OK | $334.44 | — |
| OR | $306.89 | — |
| PA | $301.13 | — |
| PR | $334.44 | — |
| RI | $325.22 | — |
| SC | $334.44 | — |
| SD | $334.44 | — |
| TN | $334.44 | — |
| TX | $334.44 | — |
| UT | $334.44 | — |
| VA | $311.94 | — |
| VI | $334.44 | — |
| VT | $306.44 | — |
| WA | $334.44 | — |
| WI | $303.68 | — |
| WV | $334.44 | — |
| WY | $328.59 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $25.61 to $30.13 depending on state and rural status.
Former-CBA payment limits: ceiling $30.13 · floor $25.61
| State | Non-rural | Rural |
|---|---|---|
| AK | $30.13 | — |
| AL | $27.67 | — |
| AR | $29.85 | — |
| AZ | $30.13 | — |
| CA | $30.13 | — |
| CO | $28.37 | — |
| CT | $28.34 | — |
| DC | $27.80 | — |
| DE | $27.74 | — |
| FL | $30.13 | — |
| GA | $28.40 | — |
| HI | $30.13 | — |
| IA | $30.13 | — |
| ID | $29.21 | — |
| IL | $30.13 | — |
| IN | $25.61 | — |
| KS | $30.13 | — |
| KY | $30.13 | — |
| LA | $30.13 | — |
| MA | $27.60 | — |
| MD | $28.15 | — |
| ME | $27.60 | — |
| MI | $30.13 | — |
| MN | $27.86 | — |
| MO | $30.13 | — |
| MS | $30.13 | — |
| MT | $27.61 | — |
| NC | $28.62 | — |
| ND | $30.13 | — |
| NE | $30.13 | — |
| NH | $27.60 | — |
| NJ | $27.95 | — |
| NM | $30.13 | — |
| NV | $30.13 | — |
| NY | $30.13 | — |
| OH | $30.13 | — |
| OK | $30.13 | — |
| OR | $27.64 | — |
| PA | $27.12 | — |
| PR | $30.13 | — |
| RI | $29.29 | — |
| SC | $30.13 | — |
| SD | $30.13 | — |
| TN | $30.13 | — |
| TX | $30.13 | — |
| UT | $30.13 | — |
| VA | $28.10 | — |
| VI | $30.13 | — |
| VT | $27.60 | — |
| WA | $30.13 | — |
| WI | $27.35 | — |
| WV | $30.13 | — |
| WY | $29.60 | — |
RR + KF — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $28.43 to $33.44 depending on state and rural status.
Former-CBA payment limits: ceiling $33.44 · floor $28.42
| State | Non-rural | Rural |
|---|---|---|
| AK | $33.44 | — |
| AL | $30.70 | — |
| AR | $33.12 | — |
| AZ | $33.44 | — |
| CA | $33.44 | — |
| CO | $31.48 | — |
| CT | $31.45 | — |
| DC | $30.86 | — |
| DE | $30.80 | — |
| FL | $33.44 | — |
| GA | $31.51 | — |
| HI | $33.44 | — |
| IA | $33.44 | — |
| ID | $32.44 | — |
| IL | $33.44 | — |
| IN | $28.43 | — |
| KS | $33.44 | — |
| KY | $33.44 | — |
| LA | $33.44 | — |
| MA | $30.64 | — |
| MD | $31.27 | — |
| ME | $30.64 | — |
| MI | $33.44 | — |
| MN | $30.92 | — |
| MO | $33.44 | — |
| MS | $33.44 | — |
| MT | $30.65 | — |
| NC | $31.76 | — |
| ND | $33.44 | — |
| NE | $33.44 | — |
| NH | $30.64 | — |
| NJ | $31.03 | — |
| NM | $33.44 | — |
| NV | $33.44 | — |
| NY | $33.44 | — |
| OH | $33.44 | — |
| OK | $33.44 | — |
| OR | $30.67 | — |
| PA | $30.11 | — |
| PR | $33.44 | — |
| RI | $32.54 | — |
| SC | $33.44 | — |
| SD | $33.44 | — |
| TN | $33.44 | — |
| TX | $33.44 | — |
| UT | $33.44 | — |
| VA | $31.20 | — |
| VI | $33.44 | — |
| VT | $30.64 | — |
| WA | $33.44 | — |
| WI | $30.37 | — |
| WV | $33.44 | — |
| WY | $32.86 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $192.08 to $225.95 depending on state and rural status.
Former-CBA payment limits: ceiling $225.95 · floor $192.06
| State | Non-rural | Rural |
|---|---|---|
| AK | $225.95 | — |
| AL | $207.44 | — |
| AR | $223.84 | — |
| AZ | $225.95 | — |
| CA | $225.95 | — |
| CO | $212.67 | — |
| CT | $212.43 | — |
| DC | $208.45 | — |
| DE | $208.08 | — |
| FL | $225.95 | — |
| GA | $212.97 | — |
| HI | $225.95 | — |
| IA | $225.95 | — |
| ID | $219.10 | — |
| IL | $225.95 | — |
| IN | $192.08 | — |
| KS | $225.95 | — |
| KY | $225.95 | — |
| LA | $225.95 | — |
| MA | $207.01 | — |
| MD | $211.20 | — |
| ME | $207.01 | — |
| MI | $225.95 | — |
| MN | $208.87 | — |
| MO | $225.95 | — |
| MS | $225.95 | — |
| MT | $207.14 | — |
| NC | $214.62 | — |
| ND | $225.95 | — |
| NE | $225.95 | — |
| NH | $207.01 | — |
| NJ | $209.57 | — |
| NM | $225.95 | — |
| NV | $225.95 | — |
| NY | $225.95 | — |
| OH | $225.95 | — |
| OK | $225.95 | — |
| OR | $207.35 | — |
| PA | $203.42 | — |
| PR | $225.95 | — |
| RI | $219.71 | — |
| SC | $225.95 | — |
| SD | $225.95 | — |
| TN | $225.95 | — |
| TX | $225.95 | — |
| UT | $225.95 | — |
| VA | $210.70 | — |
| VI | $225.95 | — |
| VT | $207.01 | — |
| WA | $225.95 | — |
| WI | $205.14 | — |
| WV | $225.95 | — |
| WY | $221.97 | — |
UE + KF — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $213.24 to $250.83 depending on state and rural status.
Former-CBA payment limits: ceiling $250.83 · floor $213.21
| State | Non-rural | Rural |
|---|---|---|
| AK | $250.83 | — |
| AL | $230.29 | — |
| AR | $248.54 | — |
| AZ | $250.83 | — |
| CA | $250.83 | — |
| CO | $236.12 | — |
| CT | $235.83 | — |
| DC | $231.40 | — |
| DE | $231.03 | — |
| FL | $250.83 | — |
| GA | $236.43 | — |
| HI | $250.83 | — |
| IA | $250.83 | — |
| ID | $243.25 | — |
| IL | $250.83 | — |
| IN | $213.24 | — |
| KS | $250.83 | — |
| KY | $250.83 | — |
| LA | $250.83 | — |
| MA | $229.82 | — |
| MD | $234.53 | — |
| ME | $229.82 | — |
| MI | $250.83 | — |
| MN | $231.90 | — |
| MO | $250.83 | — |
| MS | $250.83 | — |
| MT | $229.94 | — |
| NC | $238.30 | — |
| ND | $250.83 | — |
| NE | $250.83 | — |
| NH | $229.82 | — |
| NJ | $232.70 | — |
| NM | $250.83 | — |
| NV | $250.83 | — |
| NY | $250.83 | — |
| OH | $250.83 | — |
| OK | $250.83 | — |
| OR | $230.17 | — |
| PA | $225.86 | — |
| PR | $250.83 | — |
| RI | $243.91 | — |
| SC | $250.83 | — |
| SD | $250.83 | — |
| TN | $250.83 | — |
| TX | $250.83 | — |
| UT | $250.83 | — |
| VA | $233.96 | — |
| VI | $250.83 | — |
| VT | $229.82 | — |
| WA | $250.83 | — |
| WI | $227.77 | — |
| WV | $250.83 | — |
| WY | $246.44 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2103 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
Bill E2103 with confidence
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