Article Detail - JD DME

Original Effective Date: 06/01/2004
Revision Effective Date: 11/01/2013

Several HCPCS codes are available to suppliers when billing humidifiers. The code chosen depends on the type of respiratory device with which the humidifier will be used and the payment classification for the respiratory device.

Humidifiers should not be billed separately when used with a rented ventilator (E0450, E0454, and E0461) or rented oxygen equipment. For ventilators and oxygen equipment, payment for accessories such as humidifiers (HCPCS codes E0550, E0555, E0560) is included in the monthly rental payment. When humidifiers are billed with a rented volume ventilator or rented oxygen equipment that is covered by Medicare, they will be denied as not separately payable. If used with a rented volume ventilator or oxygen equipment that is not covered by Medicare, the humidifier will be denied with the same type of denial as the equipment.

HCPCS codes E0561 and E0562 may only be billed when used with a continuous positive airway pressure system or a respiratory assist device, and must not be billed with a ventilator or oxygen equipment.

Ventilator accessories are covered and separately payable if the patient has a purchased ventilator which is medically necessary. Oxygen accessories such as humidifiers are covered only when the beneficiary purchased oxygen equipment before June 1, 1989. If a humidifier (E0550, E0555, E0560) is provided with oxygen equipment purchased on or after June 1, 1989, it will be denied as noncovered.