From-Through Billing Requirement to Be Eliminated for Ventilator Rental

November 16, 2020

On August 27, 2020, a NewsFlash article titled “Corrections on Medi-Cal Benefit for Multi-Function Ventilator” informed providers that from-through billing for monthly rental is required for HCPCS codes E0465 (home ventilator, any type, used with invasive interface, [e.g., tracheostomy tube]), E0466 (home ventilator, any type, used with noninvasive interface, [e.g., mask, chest shell]) or E0467 (home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions).

On November 23, 2020, the Department of Health Care Services will update the system for HCPCS codes E0465, E0466 and E0467. This update will include eliminating the requirement for from-through billing.

No action is required of providers. An Erroneous Payment Correction (EPC) will address previously submitted claims that were denied due to the from-through dates of service requirement.

Policy related to this update will be published in a future Medi-Cal Update.