K0730 Ctrl dose inh drug deliv sys

Controlled dose inhalation drug delivery system

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for K0730

DMEPOS fee schedule, July 2026 (DME26-C)

Payer policies and prior authorization for K0730

8 of 8 payer prior-auth lists that name K0730 require prior authorization or set conditions: Medicare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
MedicareDMEPOS Master List (items potentially subject to PA)Allprior auth under conditionsOn the Master List; PA only if CMS selects it for the Required ListJul 30, 2026Master List of DMEPOS Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements
UnitedHealthcare Community PlanIndiana Hoosier Care ConnectINprior auth under conditionsPrior authorization required only for DME codes listed with a retail purchase or cumulative rental cost of more than $500.Oct 1, 2026Prior authorization requirements for Indiana Hoosier Care Connect Effective October 1, 2026
UnitedHealthcare Community PlanIndiana PathWays for Aging (MLTSS)INprior auth under conditionsPrior authorization required only for DME codes listed with a retail purchase or cumulative rental cost of more than $500.Oct 1, 2026Prior authorization requirements for Indiana MLTSS Pathways Effective October 1, 2026
UnitedHealthcare Community PlanMassachusetts OneCareMAprior auth under conditionsCost over $1,000Nov 1, 2025Prior authorization requirements for Massachusetts OneCare Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO)MAprior auth under conditionsPrior authorization is required only for a retail purchase or cumulative rental cost of more thanNov 1, 2025CPT® is a registered trademark of the American Medical Association. Prior authorization requirements for Massachusetts Senior Care Options Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO) and OneCareMAprior auth under conditionsCost over $1,000Oct 1, 2026Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth under conditionsCost over $500Jul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Connected (Texas MMP)TXprior auth under conditionsPrior authorization is required only for a retail purchase or cumulative rental cost of more than $1,000.Jan 1, 2015Prior 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 K0730

K0730 appears in 1 coverage policy from BlueCross BlueShield of South Carolina.

PayerPolicyRole in policyReviewedDocument
BlueCross BlueShield of South CarolinaAdvanced Therapies for Pharmacologic Treatment of Pulmonary Hypertension (CAM 50109)listed, no stanceJul 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Jun 1, 2026: conditions changed, UnitedHealthcare
  • Oct 1, 2025: conditions changed, UnitedHealthcare Community Plan

Medicaid fee-for-service

Prior authorization required or conditional in IN, KY, LA, MA, MD, ND, NE, NY, WV, WY.

  • AZ: $1563.29 (dme), effective Oct 1, 2026
  • CO: $2062.06 (chp_plus, non-facility), effective Jul 1, 2026
  • IN: $2047.39 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KY: $1551.60 (dme), effective Jan 1, 2026
  • LA: $166.02 (dme), effective Jul 1, 2012
  • MD: $2088.36 (dme), effective Apr 1, 2026
  • ND: $192.36 (dme), effective Aug 1, 2026
  • NE: $2168.94 (dme), effective Jul 1, 2026
  • NY: $101.00 (dme), effective Jul 1, 2026
  • OH: $1379.20 (dme), effective Oct 15, 2006
  • OK: $245.69 (dme), effective Jan 1, 2026
  • TX: $1586.10 (dmepos_tos_9_e_j_l_and_r, Home Health Dme), effective Jan 1, 2020
  • VT: $2162.39 (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.