HCPCS E0431 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Durable Medical Equipment • Oxygen Delivery Systems and Related Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS E0431 by major payers:
$36.41
$150.86
$126.19
$178.08
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS E0431 | ||||||
United | E0431 | $143.85 | 1851337604 - NORTHWOOD INC, CARE CONNECTION PLUS | 383064979 - / 180 MEDICAL INC / ABC HOME MEDICAL SUPPLY INC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $474.60 | 1801496195 - AIRWAY OXYGEN, INC. | 386176632 - AIRWAY OXYGEN INC / TRICOREX INC | MI | Oxygen Equipment & Supplies (DME) (332BX2000X) |
United | E0431 | $13.23 | 1063609113 - AIRLINK HOMECARE LLC | 201582708 - (MI) AIRLINK HOMECARE LLC | MI | Oxygen Equipment & Supplies (DME) (332BX2000X) |
United | E0431 | $114.76 | 1417208083 - CARELINC MEDICAL EQUIPMENT & SUPPLY CO LLC | 383378161 - (MI) CARELINC MEDICAL EQUIPMENT SUPPLY CO LLC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $186.55 | 1619541729 - BINSON'S HOSPITAL SUPPLIES, INC. | 382236525 - BINSON'S HOSPITAL SUPPLIES, INC. WRAP PLAN | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $115.55 | 1114072311 - PROMPT CARE EXPRESS P.C. | 383543609 - (MI) PROMPT CARE EXPRESS PC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $23.02 | 1235435363 - INFECTIOUS DISEASE CENTER, P.C. | 383203434 - (MI) INFECTIOUS DISEASE CENTER PC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $9.81 | 1891015160 - THE PAIN CENTER USA PLLC | 680547008 - (MI) THE PAIN CENTER USA PLLC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $13.23 | 1548226335 - METRO COMPANIES, INC, METRO MEDICAL EQUIPMENT, INC. | 382907171 - (MI) METRO COMPANIES INC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $176.97 | 1669117776 - DASCO HME, LLC, DASCO HOME MEDICAL EQUIPMENT | 311441519 - DASCO HME, LLC | MI | Oxygen Equipment & Supplies (DME) (332BX2000X) |
United | E0431 | $21.03 | 1568565729 - BINSONS MEDICAL EQUIPMENT, INC. | 382967149 - HURLEY/BINSONS MEDICAL EQUIPMENT, INC. | MI | Oxygen Equipment & Supplies (DME) (332BX2000X) |
United | E0431 | $21.03 | 1942423140 - MICHAEL R & SHARIE S CONARD, STUDIO I | 382943814 - MICHAEL R SHARIE S CONARD / STUDIO I LLC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $23.02 | 1740532035 - ORTHOPAEDIC ASSOCIATES OF GRAND RAPIDS PC, ORTHOPAEDIC ASSOCIATES OF MICHIGAN | 381971253 - (MI) ORTHOPAEDIC ASSOCIATES OF GRAND RAPIDS PC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $16.19 | 1003834946 - CARELINC MEDICAL EQUIPMENT & SUPPLY CO LLC | 383378161 - (MI) CARELINC MEDICAL EQUIPMENT SUPPLY CO LLC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | E0431 | $163.25 | 1417155508 - FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C | 383430795 - (MI) FOOT AND ANKLE SPECIALISTS OF WEST MICHIGAN, PLLC | MI | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS E0431 vs. Other Oxygen Delivery Systems and Related Supplies Codes
The HCPCS E0431 code is part of the Durable Medical Equipment services used for Oxygen Delivery Systems and Related Supplies. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS E0431 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| E0430-HCPCS | Moderate | Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
| E0431-HCPCS | Low | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
| E0433-HCPCS | Low | Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0431. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E0431 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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