Replacement soft interface material/cuffs for bi-directional static progressive stretch device
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 1 units per day (clinical), rationale: Clinical: Data
Medicare pricing for E1821
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $149.98 in the contiguous states; $149.98 to $180.04 in AK, HI, PR and VI; ceiling $149.98, floor $127.48
RR (rental), inexpensive or routinely purchased (IN): non-rural $14.95 in the contiguous states; $14.95 to $18.01 in AK, HI, PR and VI; ceiling $14.95, floor $12.71
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $112.53 in the contiguous states; $112.53 to $135.01 in AK, HI, PR and VI; ceiling $112.53, floor $95.65
Payer policies and prior authorization for E1821
1 of 1 payer prior-auth lists that name E1821 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.