Nebulizers administer vaporized medication to individuals receiving nebulized medications.
The following providers may provide spirometers:
Providers must meet any provider criteria, including accreditation, for third party insurance or Medicare. This is to assist recipients for whom MHCP is not the primary payer.
Nebulizers are covered for eligible MHCP recipients with a variety of respiratory or pulmonary conditions and diseases and other serious conditions requiring nebulized medications.
The following services (codes) are covered:
For codes E0570, E0572, E0574 and E0585, one nebulizer is allowed every five years. For code E0580, one nebulizer is allowed every three years. If more than the allowed quantity is medically necessary, providers must submit a claim with an attachment explaining the circumstances requiring replacement.
Included in Initial Dispensing
The following are included in the initial dispensing of the nebulizer:
The following are billed separately from the nebulizer:
Submit authorization request and required documentation to the authorization medical review agent.
When billing with an approved authorization:
Refer to the Billing section on the main Equipment & Supplies page and the Detailed Written Orders section for additional information.Report/Rate this page