Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
DME supplier: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Medicare pricing for E0739
DMEPOS fee schedule, July 2026 (DME26-C)
RR (rental), capped rental (CR): non-rural $1,597.66 in the contiguous states; $1,597.66 in AK, HI, PR and VI; ceiling $1,597.66, floor $1,358.01
Payer policies and prior authorization for E0739
16 of 16 payer prior-auth lists that name E0739 require prior authorization or set conditions: CarePlus Health Plans, Cigna, Humana, Medicare.
Payer
Plan
State
Prior auth
Conditions
Since
Source
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
E0739 appears in 9 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, Capital Blue Cross, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
Payer
Policy
Role in policy
Reviewed
Document
Aetna
Robotic-assisted Rehabilitation of the Extremities (0778)
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.