CPAP Accessories

E0562 HCPCS Code Description and Medicare Billing

E0562 is a HCPCS Level II code for heated humidifier. It describes a heated humidifier used with covered PAP or respiratory assist equipment. It is not a CPT code, and the humidifier's coverage depends on the related covered base device, order, and claim documentation. Review Medicare coverage, documentation, modifiers, frequency, fee references, policy links, and denial risks.

conditionalverifiedLast verified: Aug 9, 2026
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Important: Fee schedule amounts and code references do not guarantee coverage or payment. Verify billing decisions with official Medicare sources, DME MAC guidance, and qualified compliance professionals.

Coverage status

conditional

Documentation required

Yes

F2F/WOPD required list

unknown

Prescription/order

yes

Prior authorization list

unknown

Rental or purchase

rental or purchase

Fee schedule

Available

Same/similar risk

Review required

Code Summary

Heated humidifier

A heated humidifier is conditionally covered when ordered for use with a covered E0470 or E0601 PAP device.

Before billing, verify medical necessity, order requirements, proof of delivery, supplier eligibility, correct modifiers, frequency limits, and any applicable LCD or policy article.

Official Sources

official

Is E0562 a CPT code?

No. E0562 is a HCPCS Level II code, although people often search for "E0562 CPT code." CPT is HCPCS Level I and is maintained separately by the American Medical Association. Always verify the code set and payer instructions effective for the date of service.

Reimbursement Status

Coverage is marked conditional. Publication status is verified. This describes the source record, not a claim-specific coverage decision.

Documentation Requirements

Standard written order

A completed SWO must be communicated to the supplier before the claim is submitted.

Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L33718)

Proof of delivery

Maintain proof of delivery that supports the item, quantity, delivery method, and date furnished.

Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426)

Standard Written Order / Prescription

A standard written order is required before claim submission.

Clinical Evaluation / Conditions of Payment

Verify the related PAP device coverage and any applicable continued-use documentation.

Rental, Purchase, Replacement, or Supply Logic

Payment category: rental or purchase. Confirm the base PAP device remains covered and the refill is not duplicative.

E0562 Frequency and Replacement Limits

Frequency and replacement limits are pending research.

The PAP LCD describes usual maximum quantities, not automatic shipment schedules. Document an affirmative refill request, remaining supply, continued need, and delivery timing.

Modifiers

NU New equipment

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

RR Rental

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

UE Used durable medical equipment

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

KX Requirements specified in medical policy have been met

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

GA Waiver of liability statement issued

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

GY Item or service statutorily excluded

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

GZ Item or service expected to be denied

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

RA Replacement of DME item

Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.

Fee Schedule

DME26-C / Effective 2026-07-01

State lookup
Non-rural range across fee rows and states
$16.82 - $316.53
Rural range where listed
$28.02 - $280.29

Fee schedule amounts are payment references and do not prove coverage or guarantee payment.

Important: Fee schedule amounts and code references do not guarantee coverage or payment. Verify billing decisions with official Medicare sources, DME MAC guidance, and qualified compliance professionals.

Common Denials

CARC 16: Missing or Invalid Claim Information

Validate required claim loops, provider roles, identifiers, diagnosis pointers, modifiers, units, charges, and payer-specific companion-guide edits before release.

CARC 18: Duplicate Claim or Service

Lock resubmission while a claim is pending, reconcile clearinghouse and payer claim IDs, and require replacement or void indicators for true corrections.

CARC 22: Coordination of Benefits and Payer Order

Ask current coverage and employment questions, verify payer order for the date of service, and transmit complete primary adjudication data on secondary claims.

CARC 29: Timely Filing Denial

Track deadlines from the service-date rule, reconcile payer receipt rather than only transmission, and escalate unaccepted claims well before expiration.

CARC 97: Service Included in Another Payment

Check code-pair edits, global periods, status indicators, payment packaging, and modifier documentation before submitting separate lines.

CARC 109: Claim Sent to the Wrong Payer or Contractor

Validate plan, network, product, payer ID, contractor jurisdiction, and date-specific routing before submission.

Frequently Asked Questions

What is HCPCS code E0562?

E0562 is the HCPCS Level II code for a heated humidifier used with positive airway pressure or respiratory assist equipment. It is not a CPT code.

When can Medicare cover E0562?

Under the reviewed PAP and RAD policies, a heated humidifier may be separately covered when ordered for use with an applicable covered base device. The base device and all documentation requirements must be supported.

Does an E0562 fee schedule amount guarantee coverage?

No. A listed fee does not establish that the related base device is covered or that the humidifier is reasonable and necessary, correctly ordered, delivered, and billed.

Publication and Review Status

Code-level statements have attached official sources. Last reviewed: Aug 9, 2026.

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