Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 2 units per day (clinical), rationale: Anatomic Consideration
DME supplier: max 2 units per day (clinical), rationale: Anatomic Consideration
Medicare pricing for V2115
DMEPOS fee schedule, July 2026 (DME26-C)
no modifier, prosthetics and orthotics (PO): non-rural $90.56 to $120.75 in the contiguous states; $93.51 to $136.12 in AK, HI, PR and VI; ceiling $120.75, floor $90.56
Physician Fee Schedule (CY 2026, RVU26D)
Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for V2115
Payer coverage policies that name V2115
V2115 appears in 4 coverage policies from Aetna, Capital Blue Cross.
VT: $40.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $66.68 (professional), effective Jan 1, 2021
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.