`E0487` Electronic spirometer

Spirometer, electronic, includes all accessories

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 0 units per day (clinical), rationale: CMS Policy

Payer policies and prior authorization for E0487

1 of 1 payer prior-auth lists that name E0487 require prior authorization or set conditions: Humana.

Payer	Plan	State	Prior auth	Conditions	Since	Source
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

Payer coverage policies that name E0487

E0487 appears in 2 coverage policies from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Home/Ambulatory Spirometry (0572)	covered if criteria are met	Sep 1, 2026	payer document
Aetna	Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)	covered if criteria are met	Jul 9, 2026	payer document

Recent prior-auth changes

Jan 1, 2026: PA removed, Humana

Medicaid fee-for-service

Prior authorization required or conditional in IN, LA, MA, OH.

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.

E0487 Electronic spirometer