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PAYER POLICY CHANGES

E0560 Insurance Policy Changes

HCPCS E0560 is officially defined as "Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery." HCPCS E0560 is referenced in 2 tracked payer policy changes from BlueCross BlueShield of South Carolina and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS E0560 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 rules5
Payers requiring prior auth5
  • Florida Blue · Effective March 27, 2026

    Prior authorization required

    Prior Authorization List: HMO – Marketplace Qualified Health Plans

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for E0560?

AmeriHealth Caritas lists E0560 on AmeriHealth Caritas Louisiana Act 233 prior authorization service list for medicaid managed plans, with conditions. Verify with the payer before scheduling.

Does CalViva Health require prior authorization for E0560?

CalViva Health lists E0560 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 Centene require prior authorization for E0560?

Centene lists E0560 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for E0560?

Community Health Plan of Imperial Valley lists E0560 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Florida Blue require prior authorization for E0560?

Florida Blue lists E0560 on Prior Authorization List: HMO – Marketplace Qualified Health Plans for exchange plans (list dated March 27, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS E0560?

There are 2 tracked policy changes affecting HCPCS E0560, including updates from BlueCross BlueShield of South Carolina, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS E0560?

Payers that have issued tracked updates for HCPCS E0560 include: BlueCross BlueShield of South Carolina, Blue Cross & Blue Shield of Mississippi.

How do I get notified when HCPCS E0560 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS E0560. 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 E0560?

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.

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Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for E0560 in one place.

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