E2508 HCPCS code: Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device
E2508 is the HCPCS Level II code for speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device. The 2026 Medicare DMEPOS fee schedule pays $5,097.15 to $6,116.60 (NU, new equipment, purchased) 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 fell 60% from 2022 to 2024 (116 to 46 services). In 2024, 1 suppliers billed Medicare for E2508 (purchases), serving 46 beneficiaries. Its average fee ranks 6 of 7 E25 codes billed NU (family range $559.40–$9,682.09).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2004-01-01 |
| Last action effective | 2019-01-01 |
2026 Medicare DMEPOS fee schedule for E2508
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $5,097.15 | $6,116.60 | $5,097.15 | $4,332.58 |
| RR | rental (monthly) | $509.71 | $611.68 | $509.71 | $433.25 |
| UE | used equipment, purchased | $3,822.88 | $4,587.46 | $3,822.88 | $3,249.45 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $5,097.15 | — |
| AL | NU | $5,097.15 | — |
| AR | NU | $5,097.15 | — |
| AZ | NU | $5,097.15 | — |
| CA | NU | $5,097.15 | — |
| CO | NU | $5,097.15 | — |
| CT | NU | $5,097.15 | — |
| DC | NU | $5,097.15 | — |
| DE | NU | $5,097.15 | — |
| FL | NU | $5,097.15 | — |
| GA | NU | $5,097.15 | — |
| HI | NU | $5,097.15 | — |
| IA | NU | $5,097.15 | — |
| ID | NU | $5,097.15 | — |
| IL | NU | $5,097.15 | — |
| IN | NU | $5,097.15 | — |
| KS | NU | $5,097.15 | — |
| KY | NU | $5,097.15 | — |
| LA | NU | $5,097.15 | — |
| MA | NU | $5,097.15 | — |
| MD | NU | $5,097.15 | — |
| ME | NU | $5,097.15 | — |
| MI | NU | $5,097.15 | — |
| MN | NU | $5,097.15 | — |
| MO | NU | $5,097.15 | — |
| MS | NU | $5,097.15 | — |
| MT | NU | $5,097.15 | — |
| NC | NU | $5,097.15 | — |
| ND | NU | $5,097.15 | — |
| NE | NU | $5,097.15 | — |
| NH | NU | $5,097.15 | — |
| NJ | NU | $5,097.15 | — |
| NM | NU | $5,097.15 | — |
| NV | NU | $5,097.15 | — |
| NY | NU | $5,097.15 | — |
| OH | NU | $5,097.15 | — |
| OK | NU | $5,097.15 | — |
| OR | NU | $5,097.15 | — |
| PA | NU | $5,097.15 | — |
| PR | NU | $6,116.60 | — |
| RI | NU | $5,097.15 | — |
| SC | NU | $5,097.15 | — |
| SD | NU | $5,097.15 | — |
| TN | NU | $5,097.15 | — |
| TX | NU | $5,097.15 | — |
| UT | NU | $5,097.15 | — |
| VA | NU | $5,097.15 | — |
| VI | NU | $5,097.15 | — |
| VT | NU | $5,097.15 | — |
| WA | NU | $5,097.15 | — |
| WI | NU | $5,097.15 | — |
| WV | NU | $5,097.15 | — |
| WY | NU | $5,097.15 | — |
| AK | RR | $509.71 | — |
| AL | RR | $509.71 | — |
| AR | RR | $509.71 | — |
| AZ | RR | $509.71 | — |
| CA | RR | $509.71 | — |
| CO | RR | $509.71 | — |
| CT | RR | $509.71 | — |
| DC | RR | $509.71 | — |
| DE | RR | $509.71 | — |
| FL | RR | $509.71 | — |
| GA | RR | $509.71 | — |
| HI | RR | $509.71 | — |
| IA | RR | $509.71 | — |
| ID | RR | $509.71 | — |
| IL | RR | $509.71 | — |
| IN | RR | $509.71 | — |
| KS | RR | $509.71 | — |
| KY | RR | $509.71 | — |
| LA | RR | $509.71 | — |
| MA | RR | $509.71 | — |
| MD | RR | $509.71 | — |
| ME | RR | $509.71 | — |
| MI | RR | $509.71 | — |
| MN | RR | $509.71 | — |
| MO | RR | $509.71 | — |
| MS | RR | $509.71 | — |
| MT | RR | $509.71 | — |
| NC | RR | $509.71 | — |
| ND | RR | $509.71 | — |
| NE | RR | $509.71 | — |
| NH | RR | $509.71 | — |
| NJ | RR | $509.71 | — |
| NM | RR | $509.71 | — |
| NV | RR | $509.71 | — |
| NY | RR | $509.71 | — |
| OH | RR | $509.71 | — |
| OK | RR | $509.71 | — |
| OR | RR | $509.71 | — |
| PA | RR | $509.71 | — |
| PR | RR | $611.68 | — |
| RI | RR | $509.71 | — |
| SC | RR | $509.71 | — |
| SD | RR | $509.71 | — |
| TN | RR | $509.71 | — |
| TX | RR | $509.71 | — |
| UT | RR | $509.71 | — |
| VA | RR | $509.71 | — |
| VI | RR | $509.71 | — |
| VT | RR | $509.71 | — |
| WA | RR | $509.71 | — |
| WI | RR | $509.71 | — |
| WV | RR | $509.71 | — |
| WY | RR | $509.71 | — |
| AK | UE | $3,822.88 | — |
| AL | UE | $3,822.88 | — |
| AR | UE | $3,822.88 | — |
| AZ | UE | $3,822.88 | — |
| CA | UE | $3,822.88 | — |
| CO | UE | $3,822.88 | — |
| CT | UE | $3,822.88 | — |
| DC | UE | $3,822.88 | — |
| DE | UE | $3,822.88 | — |
| FL | UE | $3,822.88 | — |
| GA | UE | $3,822.88 | — |
| HI | UE | $3,822.88 | — |
| IA | UE | $3,822.88 | — |
| ID | UE | $3,822.88 | — |
| IL | UE | $3,822.88 | — |
| IN | UE | $3,822.88 | — |
| KS | UE | $3,822.88 | — |
| KY | UE | $3,822.88 | — |
| LA | UE | $3,822.88 | — |
| MA | UE | $3,822.88 | — |
| MD | UE | $3,822.88 | — |
| ME | UE | $3,822.88 | — |
| MI | UE | $3,822.88 | — |
| MN | UE | $3,822.88 | — |
| MO | UE | $3,822.88 | — |
| MS | UE | $3,822.88 | — |
| MT | UE | $3,822.88 | — |
| NC | UE | $3,822.88 | — |
| ND | UE | $3,822.88 | — |
| NE | UE | $3,822.88 | — |
| NH | UE | $3,822.88 | — |
| NJ | UE | $3,822.88 | — |
| NM | UE | $3,822.88 | — |
| NV | UE | $3,822.88 | — |
| NY | UE | $3,822.88 | — |
| OH | UE | $3,822.88 | — |
| OK | UE | $3,822.88 | — |
| OR | UE | $3,822.88 | — |
| PA | UE | $3,822.88 | — |
| PR | UE | $4,587.46 | — |
| RI | UE | $3,822.88 | — |
| SC | UE | $3,822.88 | — |
| SD | UE | $3,822.88 | — |
| TN | UE | $3,822.88 | — |
| TX | UE | $3,822.88 | — |
| UT | UE | $3,822.88 | — |
| VA | UE | $3,822.88 | — |
| VI | UE | $3,822.88 | — |
| VT | UE | $3,822.88 | — |
| WA | UE | $3,822.88 | — |
| WI | UE | $3,822.88 | — |
| WV | UE | $3,822.88 | — |
| WY | UE | $3,822.88 | — |
How the E2508 fee compares
| Measure | Value |
|---|---|
| Rank among 7 E25 codes billed NU (lowest = 1) | 6 |
| Family fee range (average of state fees) | $559.40–$9,682.09 |
| Rural fee uplift | — |
Who bills E2508 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1 |
| Referring clinicians | 46 |
| Medicare beneficiaries | 46 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1 | 116 |
| 2023 | 1 | 75 |
| 2024 | 1 | 46 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E2508, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 116 | 116 | $4,375.73 | $3,411.86 |
| 2023 | 75 | 75 | $4,756.42 | $3,700.74 |
| 2024 | 46 | 46 | $4,877.40 | $3,796.73 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A52469: Speech Generating Devices (SGD) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for E2508
- 2026-01-01: Average state fee (NU) rose 2.0%: $5,016.07 to $5,116.38
- 2026-01-01: Average state fee (RR) rose 2.0%: $501.61 to $511.63
- 2026-01-01: Average state fee (UE) rose 2.0%: $3,762.06 to $3,837.31
- 2004-01-01: E2508 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 E2508?
E2508 is the HCPCS Level II code for speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device. Short descriptor: "Sgd spelling phys contact".
How much does Medicare pay for E2508?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $5,097.15–$6,116.60; RR (rental (monthly)): $509.71–$611.68; UE (used equipment, purchased): $3,822.88–$4,587.46. Rural fees can be higher.
Does Medicare cover E2508?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E2508 change in 2026?
The average non-rural state fee for NU moved from $5,016.07 in 2025 to $5,116.38 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E2508 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E25 codes
- E2500 — Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time ($55.73–$668.78)
- E2502 — Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time ($170.44–$2,045.00)
- E2504 — Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time ($224.83–$2,697.60)
- E2506 — Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time ($329.61–$3,955.55)
- E2510 — Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access ($964.56–$11,574.79)
- E2511 — Speech generating software program, for personal computer or personal digital assistant
- E2512 — Accessory for speech generating device, mounting system
- E2513 — Accessory for speech generating device, electromyographic sensor ($449.12–$4,491.00)
- E2599 — Accessory for speech generating device, not otherwise classified
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 E2508
- Watch E2508 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E2508
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.