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    v1.0.28
    OpenPayerBilling CodesDurable Medical EquipmentHCPCS hcpcs-e1390-home-oxygen-concentrator-single-delivery-port
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    HCPCS Level II E1390: Oxygen Concentrator, Single Delivery Port

    Commercial payers pay $484 on average nationally for this procedure.

    HCPCS Level II code E1390 describes a single-delivery-port oxygen concentrator capable of providing ≥85% oxygen concentration at the prescribed flow rate for patients requiring supplemental oxygen; the service is durable medical equipment for long-term or home-based oxygen therapy and is typically used in the home or other outpatient settings where stationary oxygen delivery is needed.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    National Reimbursement Benchmarks

    National commercial reimbursement for HCPCS E1390 centers around BUCA’s average commercial rate of $483.80, with individual payers showing meaningful variation around that benchmark. Blue Cross Blue Shield exhibits the largest upper spread with a P75−P25 range of $474.60 ($702.40 − $242.80), and Cigna shows a relatively wide interquartile spread of $690.40 ($750.60 − $60.80). Aetna’s interquartile range is $661.30 ($750.20 − $88.90), while UnitedHealth Group is the tightest among the listed payers with a P75−P25 range of $366.00 ($442.80 − $63.80).

    In absolute terms, Blue Cross Blue Shield and Cigna present the widest IQR-based dispersion, indicating the most variability in commercial placements, while UnitedHealth Group most tightly clusters around its middle 50%. BUCA’s mean at $483.80 sits near the mid-to-upper portion of payer means, reflecting its role as an average commercial benchmark in this market context.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old patient with chronic obstructive pulmonary disease (COPD) and progressive hypoxemia is discharged home following stabilization of an exacerbation. The pulmonary team prescribes a stationary oxygen concentrator, single delivery port, capable of delivering ≥85% oxygen concentration at the prescribed flow rate for continuous or intermittent home oxygen therapy. A respiratory therapist assesses the patient’s oxygen flow requirement, conducts home safety and electrical outlet evaluation, and instructs the patient and caregiver on concentrator operation, cannula fitting, and maintenance. Durable medical equipment (DME) procurement staff submit prior authorization documentation to the patient’s insurer (for example, Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, BUCA, Medicare) including diagnosis supporting medical necessity (such as J96.11 or R09.02), a physician’s order specifying flow rate and frequency, and documented evaluation by a respiratory therapist. Delivery, setup, and training are scheduled at the patient’s residence with follow-up to verify adherence and oxygen saturation targets.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    E0431Portable gaseous oxygen system, rentalProvides ambulatory oxygen support often used with a stationary concentrator for mobility needs.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    8PModifier 8P—Performance Measure Reporting Modifier – Action Not Performed, Reason Not Otherwise Specified— is appended only to CPT Category II quality-reporting codes to indicate that the specified…- Use modifier -8P only with CPT Category II codes when the quality-measure action was not performed for an eligible patient and there is no documented reason in the medical record for omitting the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    332B00000XDurable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
    227900000XRegistered Respiratory TherapistA Registered Respiratory Therapist (RRT) is an advanced therapist who has passed standardized written and clinical simulation examinations administere…
    2278C0205XCritical Care Certified Respiratory TherapistRespiratory emergencies are commonplace in the treatment of critical care patients. Included in the assessment measurements conducted by the respirat…
    126800000XDental AssistantAn individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care se…
    322D00000XEmotionally Disturbed Childrens' Residential Treatment FacilityA residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral i…
    372600000XAdult CompanionAn individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the …
    1835E0208XEmergency Medicine PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the care for patients at the bedside in emergency medicine settings.
    207QP0002XPhysician Nutrition Specialist (Family Medicine)A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…

    Related ICD-10-CM Codes

    5 rows

    ICD-10-CM CodeDescription
    J96.01Acute respiratory failure with hypoxia
    J96.11Chronic respiratory failure with hypoxia
    J96.21Acute and chronic respiratory failure with hypoxia
    J96.91Respiratory failure, unspecified with hypoxia
    R09.02Hypoxemia

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-E0100-CANE-DURABLE-MEDICAL-EQUIPMENT-AMBULATION

    HCPCS E0100: Cane, Adjustable or Fixed, With Tip

    HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

    HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

    HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

    HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

    HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

    HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

    HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

    HCPCS Level II E0112: Underarm Wooden Crutches, Pair

    HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

    HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

    HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

    HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

    HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

    HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

    HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

    HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

    HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

    HCPCS E0118: Crutch Substitute, Lower Leg Platform

    Showing 1–10 of 670

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    E0439Stationary liquid oxygen system, rentalAlternative stationary oxygen solution for patients with higher flow or different supply needs.
    E0443Portable oxygen contents, gaseous, 1 month's supplySupplies portable oxygen cylinders used alongside concentrators for travel or backup oxygen.
    E0441Stationary oxygen contents, gaseous, 1 month's supplyMonthly oxygen cylinder supply for stationary systems when concentrator is supplemented or unavailable.