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HCPCS E0446 · Level II · DME code

E0446: Topical oxygen delivery system, not otherwise specified, HCPCS Level II DME code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for E0446

Medicare payment
paid outside OPPS
OPPS SI A: another fee schedule or payment system
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
0
MAI 3
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 1

TL;DR

HCPCS Level II E0446 reads "Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories" in the October 2026 file; it dates from 2011. Part B does not price E0446 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0446. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays E0446 under a fee schedule or payment system other than OPPS. CMS caps E0446 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. 1 active LCD and 1 billing and coding article list E0446 across 6 states: L33797 (Oxygen and Oxygen Equipment), A56025. HCPCS record: BETOS D1E (other DME); pricing indicator 00; type of service 9 (other medical items or services). Nearby codes: E0443, E0431, E0465, E0466.

E0446 descriptor and code status

The October 2026 HCPCS Level II file describes E0446 as “Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0446
FieldValue
Short descriptorTopical ox deliver sys, nos
Added to HCPCS2011-01-01
Last actionN (no maintenance), effective 2017-10-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator00: not separately priced by Part B
BETOS categoryD1E: other DME
Type of service9: other medical items or services

Medicare payment for E0446

Part B does not price E0446 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0446. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays E0446 under a fee schedule or payment system other than OPPS. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Hospital outpatient (OPPS Addendum B)

Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.

Medically Unlikely Edits for E0446

CMS caps E0446 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for E0446 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for E0446 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0446 in v323r0.

E0446 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check E0446 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0446

1 active Local Coverage Determination and 1 billing and coding article list E0446. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing E0446
ArticleTitleContractor(s)Related LCD
A56025Billing and Coding: Topical HBO and Physician Related Service Billing and Coding GuidelinesNoridian Healthcare Solutions, LLC—

Denials to expect on E0446

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E0446

CARC 151 · N362

units of E0446 exceed the practitioner MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for E0446 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for E0446 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E0446

What does HCPCS code E0446 describe?

"Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories" (short descriptor "Topical ox deliver sys, nos"), in the E section (durable medical equipment). Added 2011-01-01; last action N (no maintenance) effective 2017-10-01.

Is E0446 a CPT code?

It is not. E0446 belongs to the E section (durable medical equipment) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for E0446?

Part B does not price E0446 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0446. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays E0446 under a fee schedule or payment system other than OPPS.

How many units of E0446 can be billed per day?

CMS caps E0446 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover E0446?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 1 billing and coding article list E0446 across 6 states: L33797 (Oxygen and Oxygen Equipment), A56025.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.