HCPCS Code E0562: Heated Humidifier Used with Positive Airway Pressure Device

No. Current CMS and DMEPOS guidelines indicate that E0562 does not require prior authorization, a face-to-face visit, or a written order before delivery. However, documentation showing the medical necessity of the service and its association with a PAP device is essential. Providers should retain additional information, such as supporting clinical notes and applicable dates of service, to ensure compliance.

Yes, if medically necessary. A replacement claim for E0562 may be covered for reasons such as upgrade, malfunction, or damage beyond normal wear. Coverage depends on the payer, so include a clear narrative in the remarks (e.g., replacement due to PAP upgrade) to reduce denial risk. Some payers, including Medicare, may limit frequency.

No. E0562 is only applicable when a PAP device (such as E0601 or E0470) is covered and appropriately billed. If the PAP device is non-covered, the humidifier and its accessories, whether heated or non-heated, will also be denied. Coverage for accessories is contingent upon the coverage of the primary device and the documented illness being treated.