E0470 HCPCS code: Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)

E0470 is the HCPCS Level II code for respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device). The 2026 Medicare DMEPOS fee schedule pays $129.84 to $237.27 (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 1 per day on DME suppliers. Medicare volume rose 4% from 2022 to 2024 (520,532 to 540,678 services). In 2024, 4,008 suppliers billed Medicare for E0470 (rentals), serving 94,816 beneficiaries; Texas, California, Florida accounted for 20% of services. Its average fee ranks 9 of 19 E04 codes billed RR (family range $5.28–$1,572.12); rural fees run 60% higher.

Code details

FieldValue
SectionE codes — Durable medical equipment
Coverage codeD — Special coverage instructions apply
Pricing indicator36 — DMEPOS: capped rental item
BETOS categoryD1E — Other durable medical equipment
Added2004-01-01
Last action effective2004-01-01

2026 Medicare DMEPOS fee schedule for E0470

ModifierMeaningLowest state feeHighest state feeCeilingFloor
RRrental (monthly)$129.84$237.27——
StateModifierFeeRural fee
AKRR$226.66—
ALRR$133.94$219.43
ARRR$133.94$232.10
AZRR$133.39$208.36
CARR$132.96$225.75
CORR$136.68$232.10
CTRR$135.49$221.73
DCRR$129.84$208.36
DERR$129.84$208.36
FLRR$133.94$217.50
GARR$133.94$232.10
HIRR$237.27—
IARR$135.67$232.10
IDRR$136.68$232.10
ILRR$136.67$232.10
INRR$136.67$232.10
KSRR$135.67$232.10
KYRR$133.94$232.10
LARR$133.94$232.10
MARR$135.49$216.79
MDRR$129.84$208.36
MERR$135.49$220.97
MIRR$136.67$208.36
MNRR$135.67$210.27
MORR$135.67$232.10
MSRR$133.94$217.01
MTRR$136.68$209.45
NCRR$133.94$232.10
NDRR$135.67$232.10
NERR$135.67$232.10
NHRR$135.49$215.58
NJRR$129.84$208.36
NMRR$133.39$225.99
NVRR$132.96$208.36
NYRR$129.84$232.10
OHRR$136.67$232.10
OKRR$133.39$232.10
ORRR$132.96$228.84
PARR$129.84$208.36
PRRR$134.93—
RIRR$135.49$220.55
SCRR$133.94$232.10
SDRR$135.67$232.10
TNRR$133.94$232.10
TXRR$133.39$232.10
UTRR$136.68$226.71
VARR$133.94$232.10
VIRR$231.46—
VTRR$135.49$216.30
WARR$132.96$232.10
WIRR$136.67$230.87
WVRR$133.94$232.10
WYRR$136.68$232.10

How the E0470 fee compares

MeasureValue
Rank among 19 E04 codes billed RR (lowest = 1)9
Family fee range (average of state fees)$5.28–$1,572.12
Rural fee uplift60.4%

Who bills E0470 (2024)

MeasureValue
Suppliers billing rentals4,008
Suppliers billing purchases17
Referring clinicians24,110
Medicare beneficiaries94,816
States with claims56
Share of services in top 3 states (Texas, California, Florida)20%
YearSuppliersBeneficiaries
20224,05790,948
20234,01894,083
20244,00894,816

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for E0470, 2022–2024

YearServicesBeneficiariesAvg. allowedAvg. paid
2022520,53290,948$118.01$87.68
2023563,92594,083$127.96$95.28
2024540,67894,816$123.30$91.48

States with the most E0470 services (2024)

StateServicesAvg. paid
Texas38,874$90.04
California36,942$82.22
Florida33,582$82.77
Ohio25,341$93.53
Pennsylvania21,820$83.13

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
DME suppliers1Nature of Equipment

Medicare policy articles for this code

Covered diagnoses (1 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

ICD-10-CMDiagnosisArticles listing it
G47.33Obstructive sleep apnea (adult) (pediatric)1

What changed for E0470

Frequently asked questions

What is HCPCS code E0470?

E0470 is the HCPCS Level II code for respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device). Short descriptor: "Rad w/o backup non-inv intfc".

How much does Medicare pay for E0470?

Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $129.84–$237.27. Rural fees can be higher.

Does Medicare cover E0470?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Which diagnoses support coverage for E0470?

Medicare policy articles that cite E0470 list 1 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include G47.33 (Obstructive sleep apnea (adult) (pediatric)). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for E0470 change in 2026?

The average non-rural state fee for RR moved from $136.24 in 2025 to $139.84 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of E0470 can be billed per day?

1 on DME suppliers (NCCI medically unlikely edits).

Related E04 codes

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

Sources: CMS HCPCS Level II release October 2026; 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.

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