E1905 HCPCS - VIRTUAL REALITY COGNITIVE BEHAVIORAL THERAPY DEVICE (CBT), INCLUDING PRE-PROGRAMMED THERAPY SOFTWARE

Code Information

HCPCS Code: E1905
Sequence Number: 0010
Short Description: Vr cbt therapy
Long Description: Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software
Date Added: 4/1/2023
Action Code: N - No maintenance for this code
Action Effective Date: 10/1/2023
Classification: Durable Medical Equipment
Coding System: HCPCS

Pricing Indicator Code:
- 36 - Capped rental DME (price subject to floors and ceilings)
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	E1905
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software
HCPCS Short Description	Vr cbt therapy
HCPCS Pricing Indicator Code 1	36 - Capped rental DME (price subject to floors and ceilings)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	D1E - Other DME
HCPCS Type Of Service Code 1	R - Rental of DME
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	4/1/2023
HCPCS Action Effective Date	10/1/2023
HCPCS Action Code	N - No maintenance for this code