E0465 HCPCS code: Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)
E0465 is the HCPCS Level II code for home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube). The 2026 Medicare DMEPOS fee schedule pays $1,113.72 to $2,261.71 (RR, rental (monthly)) depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 2 per day on DME suppliers. Medicare volume fell 9% from 2022 to 2024 (45,586 to 41,685 services). In 2024, 935 suppliers billed Medicare for E0465 (rentals), serving 3,748 beneficiaries; California, New York, Texas accounted for 31% of services. Its average fee ranks 14 of 19 E04 codes billed RR (family range $5.28–$1,572.12).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 31 — DMEPOS: frequently serviced item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2016-01-01 |
| Last action effective | 2016-01-01 |
2026 Medicare DMEPOS fee schedule for E0465
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $1,113.72 | $2,261.71 | $1,360.33 | $1,156.28 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $1,113.72 | — |
| AL | RR | $1,156.28 | — |
| AR | RR | $1,327.91 | — |
| AZ | RR | $1,360.33 | — |
| CA | RR | $1,156.28 | — |
| CO | RR | $1,156.28 | — |
| CT | RR | $1,360.33 | — |
| DC | RR | $1,224.88 | — |
| DE | RR | $1,360.33 | — |
| FL | RR | $1,360.33 | — |
| GA | RR | $1,360.33 | — |
| HI | RR | $1,190.93 | — |
| IA | RR | $1,291.69 | — |
| ID | RR | $1,166.61 | — |
| IL | RR | $1,360.33 | — |
| IN | RR | $1,156.28 | — |
| KS | RR | $1,309.75 | — |
| KY | RR | $1,360.33 | — |
| LA | RR | $1,192.96 | — |
| MA | RR | $1,360.33 | — |
| MD | RR | $1,156.28 | — |
| ME | RR | $1,265.07 | — |
| MI | RR | $1,360.33 | — |
| MN | RR | $1,360.33 | — |
| MO | RR | $1,268.08 | — |
| MS | RR | $1,156.28 | — |
| MT | RR | $1,188.26 | — |
| NC | RR | $1,360.33 | — |
| ND | RR | $1,360.33 | — |
| NE | RR | $1,314.68 | — |
| NH | RR | $1,360.33 | — |
| NJ | RR | $1,360.33 | — |
| NM | RR | $1,311.33 | — |
| NV | RR | $1,360.33 | — |
| NY | RR | $1,360.33 | — |
| OH | RR | $1,360.33 | — |
| OK | RR | $1,360.33 | — |
| OR | RR | $1,333.16 | — |
| PA | RR | $1,360.33 | — |
| PR | RR | $2,261.71 | — |
| RI | RR | $1,360.33 | — |
| SC | RR | $1,156.28 | — |
| SD | RR | $1,360.33 | — |
| TN | RR | $1,360.33 | — |
| TX | RR | $1,360.33 | — |
| UT | RR | $1,249.23 | — |
| VA | RR | $1,358.87 | — |
| VI | RR | $1,360.33 | — |
| VT | RR | $1,193.68 | — |
| WA | RR | $1,156.28 | — |
| WI | RR | $1,164.25 | — |
| WV | RR | $1,360.33 | — |
| WY | RR | $1,360.33 | — |
How the E0465 fee compares
| Measure | Value |
|---|---|
| Rank among 19 E04 codes billed RR (lowest = 1) | 14 |
| Family fee range (average of state fees) | $5.28–$1,572.12 |
| Rural fee uplift | — |
Who bills E0465 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | 935 |
| Suppliers billing purchases | — |
| Referring clinicians | 3,464 |
| Medicare beneficiaries | 3,748 |
| States with claims | 52 |
| Share of services in top 3 states (California, New York, Texas) | 31% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 980 | 4,199 |
| 2023 | 959 | 3,886 |
| 2024 | 935 | 3,748 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0465, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 45,586 | 4,199 | $1,105.17 | $857.76 |
| 2023 | 43,391 | 3,886 | $1,200.58 | $925.45 |
| 2024 | 41,685 | 3,748 | $1,229.25 | $947.86 |
States with the most E0465 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 7,514 | $863.24 |
| New York | 2,829 | $1,007.10 |
| Texas | 2,547 | $986.44 |
| Florida | 2,455 | $1,004.86 |
| Pennsylvania | 2,020 | $996.12 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Nature of Equipment |
What changed for E0465
- 2026-01-01: Average state fee (RR) rose 2.0%: $1,282.75 to $1,308.41
- 2016-01-01: E0465 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code E0465?
E0465 is the HCPCS Level II code for home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube). Short descriptor: "Home vent invasive interface".
How much does Medicare pay for E0465?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $1,113.72–$2,261.71. Rural fees can be higher.
Does Medicare cover E0465?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E0465 change in 2026?
The average non-rural state fee for RR moved from $1,282.75 in 2025 to $1,308.41 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0465 can be billed per day?
2 on DME suppliers (NCCI medically unlikely edits).
Related E04 codes
- E0424 — Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing ($94.56–$177.16)
- E0425 — Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
- E0430 — Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing
- E0431 — Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing ($21.24–$88.58)
- E0433 — Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge ($46.28–$88.58)
- E0434 — Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing ($46.28–$88.58)
- E0435 — Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor
- E0439 — Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing ($94.56–$177.16)
- E0440 — Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
- E0441 — Stationary oxygen contents, gaseous, 1 month's supply = 1 unit ($61.92–$75.90)
- E0442 — Stationary oxygen contents, liquid, 1 month's supply = 1 unit ($61.92–$75.90)
- E0443 — Portable oxygen contents, gaseous, 1 month's supply = 1 unit ($56.56–$72.51)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under E0465
- Watch E0465 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0465
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.