HCPCS Level II › E codes E0482 Cough stimulating deviceCough stimulating device, alternating positive and negative airway pressure
Medicare coverage: Carrier judgment 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 (policy), rationale: Code Descriptor / CPT Instruction Medicare pricing for E0482 DMEPOS fee schedule, July 2026 (DME26-C) RR (rental), capped rental (CR): non-rural $520.93 to $612.86 in the contiguous states; $576.71 to $718.71 in AK, HI, PR and VI; ceiling $612.86, floor $520.93 Payer policies and prior authorization for E0482 23 of 23 payer prior-auth lists that name E0482 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Blue Shield of California Promise Health Plan, CarePlus Health Plans, Humana, Medicare, Rocky Mountain Health Plans, UnitedHealthcare Community Plan.
Payer Plan State Prior auth Conditions Since Source Blue Shield of California Promise Health Plan Promise Health Plan Medi-Cal CA prior auth required Sep 1, 2026 Medi-Cal Prior Authorization List Medicare DMEPOS Master List (items potentially subject to PA) All prior auth under conditions On the Master List; PA only if CMS selects it for the Required List Jul 30, 2026 Master List of DMEPOS Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements Blue Cross and Blue Shield of Texas Texas PA exemption (gold card), outpatient, fully insured TX prior auth required Gold-card exemption available Jul 1, 2026 BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) CarePlus Health Plans CarePlus Health Plans FL prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana D-SNP (FL) FL prior auth required Jan 1, 2027 1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List Humana Humana D-SNP (IL) IL prior auth required Jan 1, 2027 Humana Dual Fully Integrated Illinois Prior Authorization and Notification List Humana Humana D-SNP (IN) IN prior auth required Jan 1, 2027 *New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List Humana Humana D-SNP (MI) MI prior auth required Jan 1, 2027 1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List Humana Humana D-SNP (SC) SC prior auth required Jan 1, 2027 Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List Humana Humana D-SNP (VA) VA prior auth required Jan 1, 2027 Virginia Prior Authorization and Notification List Humana Humana D-SNP (VA) VA prior auth required Jan 1, 2027 Virginia Prior Authorization and Notification List Humana Humana Healthy Horizons FL prior auth required Jan 1, 2027 1102002FL1026 FLHN8CBEN Humana Healthy Horizons in Florida Preauthorization and Notification List Humana Humana Healthy Horizons IN prior auth required Jan 1, 2027 1 Humana Healthy Horizons® in Indiana Preauthorization and Notification List (PAL) for Indiana PathWays for Aging Please note the term prior authorization when used in this communication, is defined a Humana Humana Healthy Horizons LA prior auth required Jan 1, 2027 Humana Healthy Horizons in Louisiana Prior Authorization and Notification List To Except where noted via links on the following pages, prior authorization requests for medical services may be initiate Humana Humana Healthy Horizons OH prior auth required Jan 1, 2027 555201OH0924-B OHHMZG2EN Humana Healthy Horizons® in Ohio Prior Authorization Notification List (PAL) The following preauthorization and notification list Humana Humana Healthy Horizons OK prior auth required Jan 1, 2027 Humana Healthy Horizons® in Oklahoma Prior Authorization Notification List (PAL) The following preauthorization and notification list Humana Humana Healthy Horizons SC prior auth required Jan 1, 2027 Humana Healthy Horizons in South Carolina Prior authorization and Notification List The following list describes services and medications that are commonly reviewed and may require additional clinical Humana Humana Healthy Horizons VA prior auth required Jan 1, 2027 Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL) Humana Humana MA and D-SNP All prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana Puerto Rico MA and Dual Medicare-Medicaid PR prior auth required Nov 3, 2025 Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification Humana Oak Street Health All prior auth required Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management Rocky Mountain Health Plans Rocky Mountain Medicare Advantage D-SNP CO prior auth required Feb 1, 2025 Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 UnitedHealthcare Community Plan UnitedHealthcare Community Plan of Kentucky KY prior auth under conditions Cost over $500 Jul 1, 2026 Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026
Payer coverage policies that name E0482 E0482 appears in 5 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Rhode Island, Cigna.
Payer Policy Role in policy Reviewed Document Aetna Chest Physiotherapy and Airway Clearance Devices (0067) covered if criteria are met Mar 18, 2026 payer document Aetna Pulse Oximetry and Capnography for Home Use (0339) listed, no stance (range E0455-E0484) May 21, 2026 payer document Anthem Mechanical Insufflation-Exsufflation Devices (CG-DME-54) covered if criteria are met May 14, 2026 payer document Blue Cross & Blue Shield of Rhode Island Multifunction Home VentilatorsPAYMENT POLICY | 2 listed, no stance May 15, 2024 payer document Cigna Airway Clearance Devices in the Ambulatory Setting (0069) covered if criteria are met Nov 9, 2025 payer document
Recent prior-auth changes Jan 1, 2027: PA added, Humana Jan 1, 2027: PA added, Humana Jan 1, 2027: PA added, Humana Jul 1, 2026: PA removed, HealthSpring Jan 1, 2026: PA removed, Humana Mar 1, 2025: PA removed, Rocky Mountain Health Plans Mar 1, 2025: PA removed, Rocky Mountain Health Plans Medicaid fee-for-service Prior authorization required or conditional in CO, FL, IL, IN, KY, LA, MA, MD, MS, ND, NE, NY, OH, VA, WA, WV.
AZ: $1596.90 (dme), effective Oct 1, 2026 CO: $5143.73 (chp_plus, non-facility), effective Jul 1, 2026 IL: $331.55 (dme), effective Jan 1, 2026 IN: $5107.14 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2025 KS: $490.29 (default), effective Jul 1, 2026 KY: $6128.60 (dme), effective Jan 1, 2026 LA: $4455.81 (dme), effective Feb 1, 2013 MD: $4913.43 (dme), effective Apr 1, 2026 MS: $2196.70 (comprehensive), effective Jul 1, 2026 ND: $551.79 (dme), effective Aug 1, 2026 NE: $536.26 (dme), effective Jul 1, 2026 NY: $191.90 (dme), effective Jul 1, 2026 OH: $4022.80 (dme), effective Jan 1, 2024 OK: $367.72 (dme), effective Jan 1, 2026 TX: $314.60 (dmepos_tos_9_e_j_l_and_r, Home Health Dme), effective Apr 1, 2019 VA: $5467.85 (dme), effective Dec 1, 2026 VT: $5394.04 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $591.41 (respiratory), effective Jul 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.