Skip to main content
HCPCS E0467 · Level II · DME code

E0467: Home ventilator, multi-function respiratory device, 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); DMEPOS fee schedule: DME26-D (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). Next CMS release: January 1, 2027 (quarterly update).

Key facts for E0467

Medicare payment
$1,363.67 to $1,593.08
DMEPOS non-rural state fees (RR)
Coverage code
D
special coverage instructions apply
DME supplier MUE
2
MAI 3
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

E0467 is a Level II code from the E section (durable medical equipment), in use since 2019: "Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions". The October 2026 DMEPOS fee schedule (category FS, frequently serviced items) sets E0467 at RR (rental) $1,363.67 in MS to $1,593.08 in CT, rural $1,389.96 to $1,620.72. CMS caps E0467 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 2 (MAI 3, Nature of Equipment) units per day in the 2026 Q4 MUE tables. No current LCD or billing article lists E0467; its HCPCS coverage code is D (special coverage instructions apply). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1E (other DME); pricing indicator 31; type of service R (rental of DME). 3 other active codes open with "Home ventilator"; related codes: E0466, E0465, E0468, E0470.

E0467 descriptor and code status

The October 2026 HCPCS Level II file describes E0467 as “Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0467
FieldValue
Short descriptorHome vent multi-function
Added to HCPCS2019-01-01
Last actionN (no maintenance), effective 2019-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator31: DMEPOS frequently serviced DME (floors and ceilings)
BETOS categoryD1E: other DME
Type of serviceR: rental of DME

Medicare payment for E0467

The October 2026 DMEPOS fee schedule (category FS, frequently serviced items) sets E0467 at RR (rental) $1,363.67 in MS to $1,593.08 in CT, rural $1,389.96 to $1,620.72. 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.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category FS (frequently serviced items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for E0467 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
RR (rental)—$1,363.67 (MS) to $1,593.08 (CT)$1,389.96 (MS) to $1,620.72 (IL)AK $1,431.35, HI $1,507.36, PR $2,497.29, VI $1,606.99

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for E0467

CMS caps E0467 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 2 (MAI 3, Nature of Equipment) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for E0467 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 supplier23 Date of Service Edit: ClinicalNature of Equipment

The MUE lookup for E0467 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0467 in v323r0.

E0467 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 E0467 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0467

No current LCD or billing and coding article lists E0467. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on E0467

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of E0467 exceed the DME supplier MUE of 2 per date of service

CARC 4

the RR payment modifier is missing or does not match the item

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for E0467 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for E0467 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E0467

What does HCPCS code E0467 describe?

"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions" (short descriptor "Home vent multi-function"), in the E section (durable medical equipment). Added 2019-01-01.

Is E0467 a CPT code?

It is not. E0467 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 E0467?

The October 2026 DMEPOS fee schedule (category FS, frequently serviced items) sets E0467 at RR (rental) $1,363.67 in MS to $1,593.08 in CT, rural $1,389.96 to $1,620.72.

How many units of E0467 can be billed per day?

CMS caps E0467 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 2 (MAI 3, Nature of Equipment) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover E0467?

No current LCD or billing article lists E0467; its HCPCS coverage code is D (special coverage instructions apply).

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.