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PAYER POLICY CHANGES

E0467 Insurance Policy Changes

HCPCS E0467 is officially defined as "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." HCPCS E0467 is referenced in 11 tracked payer policy changes from Capital Blue Cross, UnitedHealthcare, and 9 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS E0467 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules11
Payers requiring prior auth11
  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • Florida Blue · Effective March 27, 2026

    Prior authorization required

    Prior Authorization List: HMO – Marketplace Qualified Health Plans

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for E0467?

AmeriHealth Caritas lists E0467 on AmeriHealth Caritas Louisiana Act 233 prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for E0467?

Anthem BCBS lists E0467 on List of items and services that require prior authorization (Medicaid IN) for medicaid managed plans (list dated February 11, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for E0467?

BCBS Michigan lists E0467 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for E0467?

CalViva Health lists E0467 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Capital Blue Cross require prior authorization for E0467?

Capital Blue Cross lists E0467 on Capital Blue Cross single source preauthorization code list for commercial plans. Verify with the payer before scheduling.

What insurance policy changes affect HCPCS E0467?

There are 11 tracked policy changes affecting HCPCS E0467, including updates from Capital Blue Cross, UnitedHealthcare, L.A. Care Health Plan. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS E0467?

Payers that have issued tracked updates for HCPCS E0467 include: Capital Blue Cross, UnitedHealthcare, L.A. Care Health Plan, BlueCross BlueShield of South Carolina, Colorado Medicaid, Excellus BlueCross BlueShield, Regence BlueShield, Indiana Medicaid (IHCP), Medicare/CMS - Transmittals, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when HCPCS E0467 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS E0467. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS E0467?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for E0467

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for E0467 in one place.

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