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    v1.0.31
    OpenPayerBilling CodesDurable Medical EquipmentHCPCS hcpcs-e0490-oral-tongue-neuromuscular-stimulation-power-unit
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    HCPCS Level II E0490: Tongue Neuromuscular Stimulation Power/Control Unit

    HCPCS Level II code E0490 describes a power source and control electronics unit for an oral device used for neuromuscular electrical stimulation of the tongue muscle, controlled by a hardware remote; the service involves supplying and supporting the external control/power component for an intraoral therapeutic appliance, typically categorized as durable medical equipment or a device component, with the typical site of service being outpatient clinics, speech therapy centers, or durable medical equipment providers where the device is fitted and programmed.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Continuous Passive Motion Devices with Remote Monitoring or Adaptive Capabilities, Bone Growth Stimulators.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with oropharyngeal dysphagia and impaired tongue motor control following a stroke, traumatic brain injury, or progressive neuromuscular disorder. The patient experiences difficulty initiating swallow, frequent pocketing of food on the tongue, or recurrent aspiration risk identified by a speech-language pathologist (SLP) during bedside or instrumental swallowing evaluation (videofluoroscopic swallow study or fiberoptic endoscopic evaluation of swallowing).

    Clinical workflow: The SLP evaluates swallowing function and determines candidacy for neuromuscular electrical stimulation of the tongue. An interdisciplinary team (SLP, otolaryngologist or physiatrist, and durable medical equipment provider) arranges fitting and training for an intraoral stimulation device. The billing item E0490 is the power source and control electronics unit for an oral appliance that delivers neuromuscular electrical stimulation of the tongue and is controlled by a hardware remote. The provider documents the device prescription, medical necessity (e.g., persistent dysphagia with documented objective impairment), device training session, and follow-up plan. Device delivery typically occurs in an outpatient rehabilitation clinic, hospital outpatient department, or home health setting with subsequent SLP visits for therapy and monitoring.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92526Treatment of swallowing dysfunction and/or oral function for feeding; individualSLP therapy sessions that commonly accompany device use to train swallowing exercises and integrate neuromuscular stimulation into therapy
    92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individualMay be billed when device training includes oral motor or speech-related exercises provided by SLP
    92610Evaluation of oral and pharyngeal swallowing functionBaseline instrumental evaluation (e.g., clinical/bedside) that can justify device prescription for dysphagia
    92612Flexible endoscopic evaluation of swallowing with video recordingInstrumental assessment (FEES) performed before or after device initiation to document physiologic effects
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visitUsed for billing miscellaneous non-DME supplies related to fitting and training of the device

    Related Modifiers

    6 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…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    235Z00000X
    2084P0800X
    332B00000X
    207R00000X
    163WA2000X
    207ZP0101X
    261QP2300X
    163WI0500X

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Continuous Passive Motion Devices with Remote Monitoring or Adaptive CapabilitiesBlue Cross Blue Shield - Rhode Island2026-12-01
    Bone Growth StimulatorsMass General Brigham Health Plan2026-12-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-12-01
    Patient Liftsuniverahealthcare2026-11-16
    Medical Car SeatsCareSource2026-11-01
    Non-Invasive Home Mechanical Ventilation (E0466)CareSource2026-11-01
    Digestive Enzyme Cartridgeshusky_health2026-11-01
    Hearing Aids and Assistive Listening Devices for Children Enrolled in Birth-to-Threehusky_health2026-11-01
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15

    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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