E0468 HCPCS code: Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions
E0468 is the HCPCS Level II code for home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions. The 2026 Medicare DMEPOS fee schedule pays $1,229.81 to $2,381.50 (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. In 2024, 21 suppliers billed Medicare for E0468 (rentals), serving 31 beneficiaries; New York, Mississippi, Ohio accounted for 69% of services. Its average fee ranks 16 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 | 2024-04-01 |
| Last action effective | 2024-04-01 |
2026 Medicare DMEPOS fee schedule for E0468
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $1,229.81 | $2,381.50 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $1,229.81 | — |
| AL | RR | $1,256.30 | — |
| AR | RR | $1,430.05 | — |
| AZ | RR | $1,455.14 | — |
| CA | RR | $1,253.58 | — |
| CO | RR | $1,258.42 | — |
| CT | RR | $1,462.47 | — |
| DC | RR | $1,327.01 | — |
| DE | RR | $1,460.04 | — |
| FL | RR | $1,453.83 | — |
| GA | RR | $1,459.41 | — |
| HI | RR | $1,287.05 | — |
| IA | RR | $1,393.83 | — |
| ID | RR | $1,268.75 | — |
| IL | RR | $1,462.47 | — |
| IN | RR | $1,258.42 | — |
| KS | RR | $1,411.89 | — |
| KY | RR | $1,462.47 | — |
| LA | RR | $1,293.30 | — |
| MA | RR | $1,462.47 | — |
| MD | RR | $1,252.62 | — |
| ME | RR | $1,367.20 | — |
| MI | RR | $1,458.01 | — |
| MN | RR | $1,462.47 | — |
| MO | RR | $1,370.22 | — |
| MS | RR | $1,247.81 | — |
| MT | RR | $1,280.37 | — |
| NC | RR | $1,462.47 | — |
| ND | RR | $1,452.30 | — |
| NE | RR | $1,416.82 | — |
| NH | RR | $1,462.47 | — |
| NJ | RR | $1,456.18 | — |
| NM | RR | $1,401.63 | — |
| NV | RR | $1,457.43 | — |
| NY | RR | $1,459.37 | — |
| OH | RR | $1,462.47 | — |
| OK | RR | $1,462.47 | — |
| OR | RR | $1,435.30 | — |
| PA | RR | $1,458.22 | — |
| PR | RR | $2,381.50 | — |
| RI | RR | $1,447.16 | — |
| SC | RR | $1,254.64 | — |
| SD | RR | $1,460.51 | — |
| TN | RR | $1,456.09 | — |
| TX | RR | $1,462.47 | — |
| UT | RR | $1,351.38 | — |
| VA | RR | $1,455.32 | — |
| VI | RR | $1,462.47 | — |
| VT | RR | $1,295.81 | — |
| WA | RR | $1,258.42 | — |
| WI | RR | $1,266.39 | — |
| WV | RR | $1,459.02 | — |
| WY | RR | $1,460.18 | — |
How the E0468 fee compares
| Measure | Value |
|---|---|
| Rank among 19 E04 codes billed RR (lowest = 1) | 16 |
| Family fee range (average of state fees) | $5.28–$1,572.12 |
| Rural fee uplift | — |
Who bills E0468 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | 21 |
| Suppliers billing purchases | — |
| Referring clinicians | 29 |
| Medicare beneficiaries | 31 |
| States with claims | 5 |
| Share of services in top 3 states (New York, Mississippi, Ohio) | 69% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0468, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 117 | 31 | $1,311.83 | $1,027.46 |
States with the most E0468 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 21 | $1,095.42 |
| Mississippi | 17 | $936.63 |
| Ohio | 14 | $1,089.24 |
| California | 12 | $940.96 |
| Louisiana | 11 | $942.84 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | CMS Policy |
What changed for E0468
- 2026-01-01: Average state fee (RR) rose 2.0%: $1,380.76 to $1,408.38
- 2024-04-01: E0468 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 E0468?
E0468 is the HCPCS Level II code for home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions. Short descriptor: "Home vent dual fnct incl all".
How much does Medicare pay for E0468?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $1,229.81–$2,381.50. Rural fees can be higher.
Does Medicare cover E0468?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E0468 change in 2026?
The average non-rural state fee for RR moved from $1,380.76 in 2025 to $1,408.38 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0468 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)
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Next steps
- Run a reimbursement report for a device billed under E0468
- Watch E0468 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0468
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.