E0491 — Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply
E0491 is a HCPCS Level II code for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply. It belongs to the Durable Medical Equipment section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of E0491 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
- DME supplier
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for E0491
- Long descriptor
- Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply
- Short descriptor
- Oral dv nm mouthpc hw remote
- Added
- October 1, 2023
- BETOS
- D1E
- Pricing indicator
- 32 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Inexpensive and routinely purchased DME. Price subject to floors and ceilings.
Codes adjacent to E0491
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E0491 is not quite right, the correct code is very often within a few positions of it.
- E0481Intrapulmonary percussive ventilation system and related accessories
- E0482Cough stimulating device, alternating positive and negative airway pressure
- E0483High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each
- E0484Oscillatory positive expiratory pressure device, non-electric, any type, each
- E0485Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment
- E0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
- E0487Spirometer, electronic, includes all accessories
- E0490Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote
- E0492Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application
- E0493Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply
- E0500Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source
- E0530Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
- E0550Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery
- E0555Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter
- E0560Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery
- E0561Humidifier, non-heated, used with positive airway pressure device
Questions about E0491
What is HCPCS code E0491?
E0491 is a HCPCS Level II code for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply. It sits in the Durable Medical Equipment section.
Does Medicare cover E0491?
The CMS HCPCS file marks E0491 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.