E0446 — Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories
E0446 is a HCPCS Level II code for topical oxygen delivery system, not otherwise specified, includes all supplies and accessories. 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 E0446 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
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 E0446
- Long descriptor
- Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories
- Short descriptor
- Topical ox deliver sys, nos
- Added
- January 1, 2011
- BETOS
- D1E
- Pricing indicator
- 00 — Not priced by Part B
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.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to E0446
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E0446 is not quite right, the correct code is very often within a few positions of it.
- E0435Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor
- E0439Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing
- E0440Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
- E0441Stationary oxygen contents, gaseous, 1 month's supply = 1 unit
- E0442Stationary oxygen contents, liquid, 1 month's supply = 1 unit
- E0443Portable oxygen contents, gaseous, 1 month's supply = 1 unit
- E0444Portable oxygen contents, liquid, 1 month's supply = 1 unit
- E0445Oximeter device for measuring blood oxygen levels non-invasively
- E0447Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)
- E0450Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)terminated
- E0455Oxygen tent, excluding croup or pediatric tents
- E0457Chest shell (cuirass)
- E0459Chest wrap
- E0460Negative pressure ventilator; portable or stationaryterminated
- E0461Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask)terminated
- E0462Rocking bed with or without side rails
Questions about E0446
What is HCPCS code E0446?
E0446 is a HCPCS Level II code for topical oxygen delivery system, not otherwise specified, includes all supplies and accessories. It sits in the Durable Medical Equipment section.
Does Medicare cover E0446?
The CMS HCPCS file marks E0446 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.