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 2 units per day (clinical), rationale: Anatomic Consideration
Medicare pricing for E0945
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $53.69 to $63.16 in the contiguous states; $53.69 to $68.25 in AK, HI, PR and VI; ceiling $63.16, floor $53.69
RR (rental), inexpensive or routinely purchased (IN): non-rural $5.36 to $6.30 in the contiguous states; $5.36 to $8.18 in AK, HI, PR and VI; ceiling $6.30, floor $5.36
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $41.57 to $48.90 in the contiguous states; $41.57 to $51.17 in AK, HI, PR and VI; ceiling $48.90, floor $41.57
Payer policies and prior authorization for E0945
Payer coverage policies that name E0945
E0945 appears in 1 coverage policy from Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
Payer
Policy
Role in policy
Reviewed
Document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)
Durable Medical Equipment (DME) Reference List (DME101.000) HCPCS Codes A9901, E0100, E0105, E0110, E0111, E0112, E0113, E0114, E0116, E0117,
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.