HCPCS Level II › E codes E1800 Adjust elbow ext & flex devDynamic adjustable elbow extension and flexion device, includes soft interface material
Medicare coverage: Carrier judgment 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 2 units per day (clinical), rationale: Anatomic Consideration Medicare pricing for E1800 DMEPOS fee schedule, July 2026 (DME26-C) RR (rental), capped rental (CR): non-rural $148.39 to $174.58 in the contiguous states; $140.52 to $222.55 in AK, HI, PR and VI; ceiling $174.58, floor $148.39 Payer policies and prior authorization for E1800 9 of 9 payer prior-auth lists that name E1800 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Humana, Rocky Mountain Health Plans, UnitedHealthcare, UnitedHealthcare Community Plan.
Payer Plan State Prior auth Conditions Since Source Blue Cross and Blue Shield of Texas Texas PA exemption (gold card), outpatient, fully insured TX prior auth required Gold-card exemption available Jul 1, 2026 BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) Humana Humana Healthy Horizons LA prior auth required Jan 1, 2027 Humana Healthy Horizons in Louisiana Prior Authorization and Notification List To Except where noted via links on the following pages, prior authorization requests for medical services may be initiate Humana Humana Healthy Horizons OH prior auth required Jan 1, 2027 555201OH0924-B OHHMZG2EN Humana Healthy Horizons® in Ohio Prior Authorization Notification List (PAL) The following preauthorization and notification list Rocky Mountain Health Plans Rocky Mountain Medicare Advantage D-SNP CO prior auth required Feb 1, 2025 Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 UnitedHealthcare UnitedHealthcare Complete (Individual & Family plans) All prior auth required Sep 1, 2026 Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 UnitedHealthcare UnitedHealthcare Individual Exchange plans All prior auth required Oct 1, 2026 Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026 UnitedHealthcare Community Plan Ohio Medicaid OH prior auth required Nov 1, 2025 Prior authorization requirements for Ohio Medicaid Effective November 1, 2025 General Information This list contains prior authorization requirements for participating UnitedHealthcare Community Plan UnitedHealthcare Community Plan UnitedHealthcare Community Plan of Kentucky KY prior auth under conditions Cost over $500 Jul 1, 2026 Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026 UnitedHealthcare Community Plan UnitedHealthcare Connected (Texas MMP) TX prior auth under conditions Prior authorization is required only for a retail purchase or cumulative rental cost of more than $1,000. Jan 1, 2015 Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U
Payer coverage policies that name E1800 E1800 appears in 17 coverage policies from Aetna, Anthem, BlueCross BlueShield of South Carolina, Centene, UnitedHealthcare.
Payer Policy Role in policy Reviewed Document Aetna Continuous Passive Motion (CPM) Machines (0010) listed, no stance Mar 5, 2026 payer document Aetna Mechanical Stretching Devices for Contracture and Joint Stiffness (0405)Advance Dynamic ROM, Pro-glide dynamic ROM, SaeboReach, EZ Turnbuckle Orthosis covered if criteria are met Jun 30, 2026 payer document Aetna Orthopedic Casts, Braces and Splints (0009) covered if criteria are met Jan 20, 2026 payer document Aetna Orthopedic Casts, Braces and Splints (0009) listed, no stance (range E1800-E1840) Jan 20, 2026 payer document Anthem Dynamic Low-Load Prolonged-Duration Stretch Devices (CG-DME-39) covered if criteria are met May 14, 2026 payer document BlueCross BlueShield of South Carolina Knee Braces, Orthopaedic Casts, Splints (CAM 147) listed, no stance Jan 1, 2026 payer document Centene Mechanical Stretching Devices for Joint Stiffness and Contracture (CP.MP.144) covered if criteria are met Oct 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (CS077.R) listed, no stance Dec 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (2026T0481BB) listed, no stance Jan 1, 2026 payer document UnitedHealthcare Mechanical Stretching Devices (for Idaho Only) (CS077ID.D) listed, no stance May 1, 2026 payer document UnitedHealthcare Mechanical Stretching Devices (for Kansas Only) (CS077KS.03) listed, no stance Dec 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (for Kentucky Only) (CS077KY.09) listed, no stance May 1, 2026 payer document UnitedHealthcare Mechanical Stretching Devices (for Nebraska Only) (CS077NE.R) listed, no stance Dec 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (for New Jersey Only) (CS077NJ.P) listed, no stance Dec 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (for New Mexico Only) (CS077NM.E) listed, no stance Dec 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (for Ohio Only) (CS077OH.F) listed, no stance Jan 1, 2026 payer document UnitedHealthcare Mechanical Stretching Devices (for Pennsylvania Only) (CS077PA.P) listed, no stance Dec 1, 2025 payer document UnitedHealthcare Mechanical Stretching Devices (for Tennessee Only) (CS077TN.P) listed, no stance Dec 1, 2025 payer document
Recent prior-auth changes Jul 1, 2026: PA added, Humana Jul 1, 2026: PA added, Humana Nov 1, 2025: PA added, UnitedHealthcare Community Plan Nov 1, 2025: PA added, uhc:pa:summary-of-changes Nov 1, 2025: PA added, uhc:pa:summary-of-changes Mar 1, 2025: PA removed, Rocky Mountain Health Plans Mar 1, 2025: PA removed, Rocky Mountain Health Plans Medicaid fee-for-service Prior authorization required or conditional in CO, IL, IN, KY, LA, MA, MD, MS, NE, OH, VA.
AZ: $1282.41 (dme), effective Oct 1, 2026 CO: $1245.49 (chp_plus, non-facility), effective Jul 1, 2026 FL: $78.87 (dme), effective Jul 1, 2026 IL: $1191.63 (dme), effective Jan 1, 2026 IN: $1454.86 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2025 KY: $148.39 (dme), effective Jan 1, 2026 LA: $72.89 (dme), effective Sep 1, 2021 MD: $1483.93 (dme), effective Apr 1, 2026 MS: $593.55 (comprehensive), effective Jul 1, 2026 NE: $152.76 (dme), effective Jul 1, 2026 OH: $1369.28 (dme), effective Jan 1, 2026 OK: $148.39 (dme), effective Jan 1, 2026 TX: $1026.35 (dmepos_tos_9_e_j_l_and_r, Medical Supplier (Dme)), effective Apr 1, 2013 VA: $5.24 (medical), effective Jan 1, 2026 VT: $1306.16 (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.