Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 0 units per day (clinical), rationale: CMS Policy
DME supplier: max 1 units per day (clinical), rationale: Nature of Equipment
Medicare pricing for E0189
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $57.53 to $63.87 in the contiguous states; $74.06 to $143.01 in AK, HI, PR and VI; rural $62.95 to $71.01
RR (rental), inexpensive or routinely purchased (IN): non-rural $5.75 to $6.39 in the contiguous states; $8.01 to $14.31 in AK, HI, PR and VI; rural $6.80 to $7.40
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $43.15 to $47.91 in the contiguous states; $54.76 to $107.26 in AK, HI, PR and VI; rural $47.21 to $53.26
Payer policies and prior authorization for E0189
1 of 1 payer prior-auth lists that name E0189 require prior authorization or set conditions: Rocky Mountain Health Plans.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.