E0491 HCPCS code: Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply
E0491 is the HCPCS Level II code for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply. The 2026 Medicare DMEPOS fee schedule pays $105.37 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers. Its average fee ranks 6 of 6 E04 codes (family range $62.10–$105.37).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2023-10-01 |
| Last action effective | 2025-01-01 |
2026 Medicare DMEPOS fee schedule for E0491
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $105.37 | $105.37 | $105.37 | $89.56 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $105.37 | — |
| AL | — | $105.37 | — |
| AR | — | $105.37 | — |
| AZ | — | $105.37 | — |
| CA | — | $105.37 | — |
| CO | — | $105.37 | — |
| CT | — | $105.37 | — |
| DC | — | $105.37 | — |
| DE | — | $105.37 | — |
| FL | — | $105.37 | — |
| GA | — | $105.37 | — |
| HI | — | $105.37 | — |
| IA | — | $105.37 | — |
| ID | — | $105.37 | — |
| IL | — | $105.37 | — |
| IN | — | $105.37 | — |
| KS | — | $105.37 | — |
| KY | — | $105.37 | — |
| LA | — | $105.37 | — |
| MA | — | $105.37 | — |
| MD | — | $105.37 | — |
| ME | — | $105.37 | — |
| MI | — | $105.37 | — |
| MN | — | $105.37 | — |
| MO | — | $105.37 | — |
| MS | — | $105.37 | — |
| MT | — | $105.37 | — |
| NC | — | $105.37 | — |
| ND | — | $105.37 | — |
| NE | — | $105.37 | — |
| NH | — | $105.37 | — |
| NJ | — | $105.37 | — |
| NM | — | $105.37 | — |
| NV | — | $105.37 | — |
| NY | — | $105.37 | — |
| OH | — | $105.37 | — |
| OK | — | $105.37 | — |
| OR | — | $105.37 | — |
| PA | — | $105.37 | — |
| PR | — | $105.37 | — |
| RI | — | $105.37 | — |
| SC | — | $105.37 | — |
| SD | — | $105.37 | — |
| TN | — | $105.37 | — |
| TX | — | $105.37 | — |
| UT | — | $105.37 | — |
| VA | — | $105.37 | — |
| VI | — | $105.37 | — |
| VT | — | $105.37 | — |
| WA | — | $105.37 | — |
| WI | — | $105.37 | — |
| WV | — | $105.37 | — |
| WY | — | $105.37 | — |
How the E0491 fee compares
| Measure | Value |
|---|---|
| Rank among 6 E04 codes (lowest = 1) | 6 |
| Family fee range (average of state fees) | $62.10–$105.37 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for E0491
- 2026-01-01: Average state fee rose 2.0%: $103.30 to $105.37
- 2023-10-01: E0491 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 E0491?
E0491 is the HCPCS Level II code for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply. Short descriptor: "Oral dv nm mouthpc hw remote".
How much does Medicare pay for E0491?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $105.37. Rural fees can be higher.
Does Medicare cover E0491?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for E0491 change in 2026?
The average non-rural state fee moved from $103.30 in 2025 to $105.37 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0491 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims; 1 on practitioner claims (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 E0491
- Watch E0491 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0491
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.