Insurance Code E0601

I have new health insurance. I was thinking of getting a travel machine but was unsure if they would pay anything for it. I called and they told me on the phone, for my policy:
Newer advance machines, not covered.
Backup machines, not covered.
Allowed 1 machine per 3 year cycle under code E0601.
Does anyone know what this code means? Will they pay only for the basic “brick”. I had one of these ”bricks” and ended up very unhappy with it. Ended up returning it. If E0601 is for “Brick Only”, I think I will just buy a travel machine direct online and pay out of pocket.
Thanks

E0601 HCPCS billing code is not limited to the bricks. It covers full data cpap and apap machines also.
Your insurance won't pay for a second machine, even a brick, for 3 years.

For a general list of CPAP related insurance codes:

HCPCS Insurance codes

If a second/travel machine is required for work, (ex: fire fighter, OTR truck driver)
some tax benefits may apply--or maybe your employer would help?
You can buy out of pocket at any time, no deductible, copayment, or paperwork.
The forum hosts, cpap.com, have given me excellent prices on brand new machines.

EO601 is ANY APAP or CPAP--brick to full bells and whistles. Your insurer doesn't care if you get the fanciest ever APAP or the dumbest low end CPAP, because they are going to pay ONE price for your machine, no matter what you get.

The DME cares what machine you get because obviously their profit margin on the dumb CPAP brick is a lot better than their profit margin on the fanciest bells and whistles APAP. So they will tell you things like "your insurance doesn't cover the fancy APAP machine." Yes, your insurance does, but they are not willing to sell the fancy APAP machine to you for the amount of reimbursement the DME provides.

Your best defense is your doctor. As your doctor to write a specific script: "Bells and Whistles Auto Machine with heated hose and humidifier, patient access to leak and AHI data, set 6 - 10 cm. Dispense as written." Let me break that down:

1. Substitute "bells and whistles" for your desired brand--we recommend ResMed or Philips Respironics because they have the best data access.
2. Heated hose only comes on the better machines.
3. Patient access to LEAK data is particularly important--ResMed makes an Escape Auto model. It has limited data, but no leak data. And leak data is VERY important. If your script species access to leak data, they can't give you an Escape (doesn't mean they still won't try).
4. Set for a range of pressures--that will forestall arguments from the DME about whether you need an APAP or not. An APAP can be run either as a CPAP or APAP, but with a CPAP you would have no choice.
5. Dispense as written means that the DME is not free to ignore any part of the script.

Contact your insurance company to make sure you understand whether you can go to any DME or you must go to an approved provider. Once you know which DME's you can use, call around and ask if each DME can fulfill the prescription as written. Don't bother with those who argue with you. If there's only one but they only carry Respironics and you want a ResMed, then decide if it's worth arguing. If so, they can always order a ResMed for you , but they really won't like that, a single order means very little profit for them.

Bottom line is don't let a DME talk you into any less of a machine than you want. You are going to have to live with it, not them.