CPM Device Billing Span Dates Calculator


Surgery Date:

CPM Applied Date:

Discharge Date:



Continuous Passive Motion (CPM) Devices

The Standard Written Order (SWO) requirements are in effect for dates of service January 1, 2020 and after.
Refer to the SWO page for the elements needed in this streamlined order.




Topic Details
  • Payment is:
    • Limited to a maximum of 21 days beginning on the date of surgery
    • Made for each day that the device is used in the patient's home within the 21 day limited coverage period
  • The discharge date is the first day Medicare can be billed
  • Surgery date is day 1 of the 21 day coverage period
Billing Narrative (E0935)
  • Type of knee surgery performed
  • Date of surgery
  • Date of application of CPM
  • Date of discharge from hospital
  • CPM treatment must start within 48 hours following a total knee replacement or a revision of a major component of a previously performed total knee replacement
  • Coverage is limited to that portion of the 3-week period following surgery during which device is used in patient's home
  • CPMs are not covered after any other type of knee/joint surgery
Payment Rules - Continuous Passive Motion Machines View coding guidelines, coverage and documentation details


Last Updated Wed, 27 Jan 2021 20:30:36 +0000

The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.

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