Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
DME supplier: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Medicare pricing for E0992
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $85.29 to $105.03 in the contiguous states; $114.62 to $231.68 in AK, HI, PR and VI; rural $111.45 to $121.62
NU-KU, inexpensive or routinely purchased (IN): non-rural $115.29 to $135.63 in the contiguous states; $115.29 to $349.39 in AK, HI, PR and VI; ceiling $135.63, floor $115.29
RR (rental), inexpensive or routinely purchased (IN): non-rural $8.53 to $10.50 in the contiguous states; $11.44 to $27.52 in AK, HI, PR and VI; rural $10.98 to $11.97
RR-KU, inexpensive or routinely purchased (IN): non-rural $11.19 to $13.17 in the contiguous states; $11.49 to $43.64 in AK, HI, PR and VI; ceiling $13.17, floor $11.19
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $63.97 to $78.77 in the contiguous states; $85.97 to $173.77 in AK, HI, PR and VI; rural $83.59 to $91.22
UE-KU, inexpensive or routinely purchased (IN): non-rural $86.46 to $101.72 in the contiguous states; $86.46 to $262.06 in AK, HI, PR and VI; ceiling $101.72, floor $86.46
Payer policies and prior authorization for E0992
1 of 1 payer prior-auth lists that name E0992 require prior authorization or set conditions: Rocky Mountain Health Plans.
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.