E0435 Oxygen system liquid portabl

Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for E0435

1 of 1 payer prior-auth lists that name E0435 require prior authorization or set conditions: Humana.

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification

Payer coverage policies that name E0435

E0435 appears in 5 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Centene.

PayerPolicyRole in policyReviewedDocument
AetnaOxygen (0002)covered if criteria are metMar 10, 2026payer document
AetnaPulse Oximetry and Capnography for Home Use (0339)listed, no stance (range E0424-E0444)May 21, 2026payer document
AnthemHome Oxygen Therapy (CG-DME-18)covered if criteria are met (range E0434-E0435)Aug 13, 2026payer document
Blue Cross & Blue Shield of MississippiOxygen (L.1.01.403)covered if criteria are metpayer document
CenteneOutpatient Oxygen Use (CP.MP.190)covered if criteria are metNov 1, 2025payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, MD, ND, OH, VA.

  • CO: $87.06 (health_first_colorado), effective Jul 1, 2026
  • ND: $659.37 (dme), effective Aug 1, 2026
  • VA: $5.07 (medical), effective Jul 1, 1996
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.