Healthcare Common Procedure Coding System (HCPCS) Code E1905 — the Medicare billing code for Virtual Reality Cognitive Behavioral Therapy (VR CBT) devices — is active, the product is verified, and reimbursement is flowing. If you’re a Durable Medical Equipment (DME) supplier who’s been looking into this category and want to know exactly what getting started looks like, this guide walks you through it from beginning to end.
And if you want to skip straight to step one: call (352) 900-3570 and the XRHealth supplier team will verify your credentials, confirm your eligibility, and walk you through your first order. Most suppliers are operationally ready within days.
Do You Already Qualify to Bill E1905?
Before anything else — you may already have everything you need.
If you are currently enrolled and accredited as a Medicare DME supplier billing other equipment categories like hospital beds, wheelchairs, or Continuous Positive Airway Pressure (CPAP) devices, you can add E1905 to your catalog without any new enrollment, additional accreditation, or special contracts. The same supplier number, the same billing privileges, the same claims process. Nothing extra required.
If you are new to Medicare DME billing — or want to confirm your current status — here is what enrollment requires:
Get accredited first. Every supplier billing Medicare for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) must be accredited by a Centers for Medicare & Medicaid Services (CMS)-approved organization. There are nine approved organizations as of early 2026, including the Accreditation Commission for Health Care (ACHC) and The Compliance Team (TCT). 1 Starting January 1, 2026, CMS now requires suppliers to be re-surveyed annually — a change from the previous three-year cycle — so ongoing compliance readiness matters more than ever. 1
Get a National Provider Identifier (NPI) for each location. An NPI is a unique identification number every healthcare supplier needs to bill Medicare. Each physical location you operate requires its own NPI, issued through the National Plan & Provider Enumeration System (NPPES). 2
Complete your enrollment application. Enrollment is done online through PECOS — the Provider Enrollment, Chain, and Ownership System — using Form CMS-855S, the official Medicare enrollment application for DME suppliers. The application fee is $730 as of 2025. 3
Post a surety bond. Most suppliers must post a $50,000 surety bond for each NPI they register — a financial guarantee to Medicare that you will follow billing rules. This is submitted to your regional enrollment contractor: Palmetto GBA for suppliers west of the Mississippi, Novitas Solutions for those east of it. 1
Stay compliant. Once enrolled, suppliers must follow 30 DMEPOS supplier standards set by CMS under federal regulation 42 CFR 424.57 — covering record-keeping, staff qualifications, and business conduct. Enrollment must be renewed every three years. 2
Once enrolled and accredited, you’re ready to bill E1905. No competitive bidding contract is required — E1905 is billed at the standard Medicare fee schedule rate, open to all enrolled suppliers. 4
Not sure where you stand? Call (352) 900-3570 and the XRHealth supplier team will confirm your current credentials and tell you exactly what — if anything — you need before your first order.
What Does the XRHealth Partnership Actually Look Like?
The XRHealth supplier model is built on a simple division of responsibilities: you handle the billing side, XRHealth handles everything else.
Your responsibilities as the supplier:
- Receive the written order from the prescribing clinician
- Verify the patient’s Medicare Part B eligibility and coverage
- Submit the E1905 claim to your Durable Medical Equipment Medicare Administrative Contractor (DME MAC) — the regional Medicare contractor that processes DME claims
- Keep required documentation on file for a minimum of seven years 5
What XRHealth takes off your plate:
- Reviewing written orders to make sure they’re complete and compliant before the device ships 6
- Shipping the device directly to the patient’s home, pre-loaded and ready to use, with HIPAA-compliant packaging and delivery confirmation
- Onboarding the patient — XRHealth’s care team handles all device orientation, therapy guidance, and ongoing patient support
- Working directly with prescribing clinicians on the clinical side, so your staff never has to
In practice, your involvement looks identical to any other direct-ship DME product: receive the order, confirm eligibility, confirm delivery, submit the claim.
Want to see what the onboarding process looks like before committing? Visit xr.health/us/dme-suppliers/ for a full overview of the partnership model — or call (352) 900-3570 and we’ll walk you through it live.
How Does an Order Actually Get Processed?
Here is the full workflow from first patient contact to paid claim:
- A referral comes in.A physician, nurse practitioner, or physician assistantrefers a patient — or contacts XRHealth or your office directly. Eligible conditions include chronic pain, anxiety, depression, Post-Traumatic Stress Disorder (PTSD), stress, and related behavioral health diagnoses.
- You verify eligibility.Confirm that the patient is actively enrolled in Medicare Part B and meets coverage criteria.XRHealth’s team supports this step for patients coming through the XRHealth intake process.
- The clinician issues a written order.The prescribing provider issues a Standard Written Order (SWO) — a formal prescription that must include the patient’s name or Medicare Beneficiary Identifier (MBI) number, a description of the device, and the provider’s name, National Provider Identifier (NPI), and signature.6 This order must be in your file before the claim is submitted. 7
- The device ships.XRHealthships the VR CBT device directly to the patient’s home. It arrives pre-loaded with FDA-registered therapy programs — no setup, no downloads, no technical troubleshooting needed from the patient or your staff. Delivery confirmation is automatically generated for your compliance file.
- XRHealthonboards the patient. XRHealth’s care team contacts the patient to confirm receipt and walk them through the device. Your office has no onboarding responsibilities.
- Yousubmitthe claim. With documentation on file, you submit the claim to your DME MAC using HCPCS Code E1905. Medicare Part B covers 80% of the approved fee schedule amount after the patient’s annual deductible. The remaining 20% is billed to the patient — and for those with Medigap supplemental insurance, that 20% is often covered as well.
Questions about a specific step in this workflow? The XRHealth supplier team can walk you through your first claim in real time. Call (352) 900-3570 to get started.
What Documentation Do You Need to Keep?
This is the most important compliance section in this guide. The number one reason DME claims get denied or reversed on audit is not a clinical dispute — it is missing or incomplete paperwork. CMS’s Comprehensive Error Rate Testing (CERT) program and Recovery Audit Contractor (RAC) reviews specifically target documentation gaps. 8
For every E1905 claim, your file must contain:
- A Standard Written Order (SWO) from the prescribing provider, with all required elements, received before the claim is submitted 67
- Proof of Delivery (POD) — a delivery confirmation that includes the patient’s identification, the delivery date, and a description of the item 5
- Clinical documentation from the patient’s medical record showing why the device was medically necessary — their diagnosis, their condition, and the clinical basis for the order 5
- All records kept for at least seven years from the date of service, available to CMS if requested 5
XRHealth supports all of these requirements directly:
- Written orders are reviewed for completeness before the device ships — catching problems before they become denied claims
- The XRHealth VR CBT Device is PDAC-verified, which means CMS already recognizes it as correctly coded under E1905 — reducing audit risk on the coding side 5
- Delivery documentation is automatically generated through XRHealth’s fulfillment process and provided directly to your compliance file
One important note: XRHealth’s support reduces the burden of documentation compliance — it does not eliminate your responsibility for it. You are the billing supplier. Maintain your own file review process and confirm all documentation is complete before submitting any E1905 claim.
Concerned about documentation risk on your first few claims? XRHealth’s team walks new supplier partners through the documentation checklist claim by claim until the process is second nature. Call (352) 900-3570 to talk through what that looks like for your operation.
How Do You Model the Revenue?
E1905 reimbursement is set by the CMS DMEPOS fee schedule — a list of approved payment amounts CMS updates quarterly. Because E1905 is not subject to competitive bidding, your rate is the standard fee schedule amount for your geographic area, not a compressed competitive bidding rate. CMS adjusts these amounts annually each January based on the Consumer Price Index for All Urban Consumers (CPI-U), with additional updates in April, July, and October. 9
To find your exact rate, pull the current DMEPOS fee schedule file from the CMS website or check with your DME MAC’s billing resources. Rates vary by location — always confirm your specific number before projecting revenue.
The revenue model is straightforward:
Revenue per order = 80% of the Medicare-approved fee schedule amount. The patient’s 20% coinsurance is billed separately to the patient or their supplemental insurer — no additional work from your billing team once the primary claim is paid.
Cost per order = minimal. Because XRHealth handles fulfillment, patient onboarding, and documentation support, your cost is essentially billing staff time for eligibility verification and claim submission — work your team already does for every other DME product. No inventory to carry, no in-home service visits, no ongoing resupply.
Volume = driven by your referral relationships. The more physicians, pain management specialists, and behavioral health providers in your network, the more orders flow in. Volume scales with outreach effort, not with new infrastructure.
The biggest risk to ROI = documentation errors. A clean first-pass claim approval rate directly determines whether this category adds margin or triggers audit exposure. Suppliers using XRHealth’s documentation support protect that rate from day one.
Want to model the numbers for your specific market before deciding? Call (352) 900-3570 and the XRHealth supplier team will walk you through current fee schedule rates and per-unit economics for your jurisdiction — no commitment required.
Common Questions From Suppliers
Does the patient need prior authorization before the device ships? No — E1905 is not on the CMS Required Prior Authorization List. Standard DMEPOS workflow applies: valid written order, eligibility verified, medical necessity documented. Always confirm with your DME MAC if any jurisdiction-specific policies apply, as these can change. 10
What if a patient has a Medicare Advantage plan instead of Original Medicare? Coverage varies. Because E1905 was created by CMS — not the American Medical Association (AMA) — some Medicare Advantage and commercial plans may not cover it. Original Medicare (Parts A and B) is the most reliable reimbursement path for this code. Always verify the specific plan’s coverage before proceeding with Medicare Advantage patients. 10
Who answers patient questions about the device? XRHealth’s care team handles everything — device questions, therapy guidance, technical issues, and clinical support. Your staff needs no VR or behavioral health expertise to support patients in this program.
What happens if a device needs to be returned or replaced? XRHealth manages all returns and replacements directly. Your involvement after delivery is limited to the claim.
How quickly can we start accepting orders? Once your supplier credentials are verified and your partnership agreement with XRHealth is in place, you can begin taking orders. There is no training requirement, no new technology to integrate, and no inventory to set up. Most suppliers are operationally ready within days of partnership execution.
Ready to Take the First Step?
Here is exactly what happens when you reach out:
- The XRHealth supplier team verifies your current DMEPOS credentials and confirms what — if anything — you need before your first order.
- We walk you through the partnership agreement and answer every operational question your billing team has.
- We process your first order together — walking you through the written order review, the eligibility check, and the claim submission step by step.
- From there, the workflow runs like any other direct-ship DME product in your catalog.
There is no lengthy onboarding. No new software. No staff retraining. Just a new, Medicare-covered product category with an established reimbursement pathway and a manufacturer partner who handles the complexity.
Visit xr.health/us/dme-suppliers/ to learn more — or call our supplier partnership team directly at (352) 900-3570. Step one takes less than ten minutes.
—
Sources
[^1]: Integral Healthcare Solutions. DMEPOS Supplier Accreditation FAQ — CMS-approved AOs, 2026 annual survey requirements. https://www.integralhs.com/dmepos-supplier-faq
[^2]: CMS. Medicare Enrollment for DMEPOS Suppliers — Steps 1 through 5. https://cms.gov/medicare/enrollment-renewal/providers-suppliers/durable-medical-equipment-prosthetics-orthotics-supplies-dmepos
[^3]: SuretyBonds.com. How to Become a DMEPOS Supplier: 5-Step Accreditation Guide. https://www.suretybonds.com/guide/federal/dmepos-accreditation
[^4]: CMS. DMEPOS Competitive Bidding Program — Updates and Important Information. March 2026. https://www.cms.gov/newsroom/fact-sheets/durable-medical-equipment-prosthetics-orthotics-supplies-competitive-bidding-program-updates
[^5]: CMS. Article — Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426). https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55426
[^6]: CMS. DMEPOS General Documentation Requirements — Standard Written Order elements. https://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/dmepos-general-documentation-requirements
[^7]: CMS. DMEPOS Order and Face-to-Face Encounter Requirements. https://www.cms.gov/data-research/monitoring-programs/medicare-fee-service-compliance-programs/medical-review-and-education/dmepos-order-requirements
[^8]: Medbill. DME Documentation Requirements & Audit Support. https://medbill.net/dme-documentation-requirements/
[^9]: NikoHealth. Medicare DME Fee Schedule — Structure, Lookup, and 2026 Updates. https://nikohealth.com/medicare-dme-fee-schedule/
[^10]: Nixon Gwilt Law. Your Guide to Virtual Reality Reimbursement in the U.S. Healthcare Market. February 2026. https://www.nixonlawgroup.com/resources/your-guide-to-virtual-reality-reimbursement-in-the-us-healthcare-market
