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HCPCS E0787 · Level II · DME code

E0787: External ambulatory infusion pump, insulin, 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). Next CMS release: January 1, 2027 (quarterly update).

Key facts for E0787

Medicare payment
not separately priced
HCPCS pricing indicator 00 (Part B)
Coverage code
I
not payable by Medicare
Practitioner MUE
0
MAI 3
OPPS status
SI E1
Non-allowed item or service
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

HCPCS Level II E0787 reads "External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing" in the October 2026 file; it dates from 2020. Part B does not price E0787 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 E0787. Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). E0787 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code I (not payable by Medicare) and any NCD. OPPS status indicator E1: Non-allowed item or service. HCPCS record: BETOS Z2 (not assigned to a BETOS category); pricing indicator 00; type of service 9 (other medical items or services). 1 other active code opens with "External ambulatory infusion pump"; related codes: E0784, E0781, E0776, E0760.

E0787 descriptor and code status

The October 2026 HCPCS Level II file describes E0787 as “External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0787
FieldValue
Short descriptorCgs dose adj insulin inf pmp
Added to HCPCS2020-01-01
Last actionN (no maintenance), effective 2020-09-15
Coverage codeI: not payable by Medicare
Pricing indicator00: not separately priced by Part B
BETOS categoryZ2: not assigned to a BETOS category
Type of service9: other medical items or services

Medicare payment for E0787

Part B does not price E0787 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 E0787. 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 E1 (Non-allowed item or service), with no separate OPPS payment rate.

Medically Unlikely Edits for E0787

Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). 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 E0787 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 E0787 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0787 in v323r0.

E0787 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 E0787 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0787

No current LCD or billing and coding article lists E0787. The HCPCS coverage code I means not payable by Medicare, and any National Coverage Determination for the service still applies.

Denials to expect on E0787

CARC 50 · N115

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

CARC 151 · N362

units of E0787 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 information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for E0787 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for E0787 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 E0787

What does HCPCS code E0787 describe?

"External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing" (short descriptor "Cgs dose adj insulin inf pmp"), in the E section (durable medical equipment). Added 2020-01-01; last action N (no maintenance) effective 2020-09-15.

Is E0787 a CPT code?

No. E0787 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for E0787?

Part B does not price E0787 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 E0787.

How many units of E0787 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). 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 E0787?

E0787 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code I (not payable by Medicare) and any NCD.

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.