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 E0944
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $55.56 to $65.37 in the contiguous states; $47.55 to $79.09 in AK, HI, PR and VI; ceiling $65.37, floor $55.56
RR (rental), inexpensive or routinely purchased (IN): non-rural $5.59 to $6.58 in the contiguous states; $4.82 to $9.88 in AK, HI, PR and VI; ceiling $6.58, floor $5.59
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $41.68 to $49.03 in the contiguous states; $35.66 to $59.33 in AK, HI, PR and VI; ceiling $49.03, floor $41.68
Payer policies and prior authorization for E0944
Medicaid fee-for-service
Prior authorization required or conditional in CO, LA, MA, NY, VA.
AZ: $66.23 (dme), effective Oct 1, 2026
CO: $0.00 (dme), effective Jul 1, 2026
FL: $13.02 (dme), effective Jul 1, 2026
IL: $22.65 (dme), effective Jan 1, 2026
IN: $54.48 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
KY: $40.16 (dme), effective Jan 1, 2026
LA: $2.63 (dme), effective Sep 1, 2021
MD: $51.64 (dme), effective Apr 1, 2026
ND: $66.75 (dme), effective Aug 1, 2026
NE: $71.56 (dme), effective Jul 1, 2026
NY: $41.31 (dme), effective Jul 1, 2026
OH: $36.70 (dme), effective Jul 26, 2007
OK: $65.37 (dme), effective Jan 1, 2026
TX: $28.90 (dmepos_tos_9_e_j_l_and_r, Home Health Dme), effective Apr 1, 2013
VA: $58.83 (dme), effective Dec 1, 2026
VT: $54.80 (outpatient_hospital_opps), effective Feb 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.