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February 19, 2026

LCD and Policy Article Revisions Summary for February 19, 2026

Joint DME MAC Publication

Outlined below are the principal changes to the DME MAC Local Coverage Determination (LCD) and Policy Article (PA) that have been revised and posted. The policy included is Nebulizers. Please review the entire LCD and PA for complete information.

Nebulizers

LCD

Nebulizers LCD

Revision Effective Date: 02/01/2026

COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:

Revised: “The following table represents the maximum milligrams/per month of inhalation drugs that are reasonable and necessary for each nebulizer drug.” to “The following table represents the maximum per month of inhalation drugs that are reasonable and necessary for each nebulizer drug.,” as clarification
Revised: “Maximum Milligrams/Month” to “Maximum Per Month” in the header of the second column within the tables that pertain to the maximums per month of inhalation drugs and solutions, as clarification
Revised: “When albuterol, levalbuterol, or metaproterenol are prescribed as rescue/supplemental medication for beneficiaries who are taking formoterol or arformoterol, the maximum milligrams/per month that are reasonably billed are:” to “When albuterol, levalbuterol, or metaproterenol are prescribed as rescue/supplemental medication for beneficiaries who are taking formoterol or arformoterol, the maximum per month that are reasonably billed are:,” as clarification
Revised: “Albuterol/Ipratroprium combination” to “Albuterol/Ipratropium combination” in the first column of the second table pertaining to inhalation drugs and solutions

02/19/2026: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary.

PA

Nebulizers PA

Revision Effective Date: 02/01/2026

CODING GUIDELINES:

Added: Long description for J7699
Removed: Billing information for claims with dates of service from January 1, 2008 through March 31, 2008 pertaining to J7602 and J7603, due to timely filing limit
Revised: “Suppliers must be sure that they use the correct billing unit or the code when calculating the number of units of service to enter on the claim.” to “Suppliers must be sure that they use the correct billing unit of the code when calculating the number of units of service to enter on the claim.”
Revised: Billing unit of service language regarding J7626 for a 0.25 mg vial and a 0.5 mg vial, as clarification
Added: Billing unit of service information regarding J7626 for a 1 mg vial, as clarification
Removed: J7627 from the billing unit of service information (budesonide, unit dose), due to non-coverage of compounded solutions
Removed: Billing information for claims with dates of service on or after November 9, 2018, through June 30, 2019 pertaining to revefenacin, due to timely filing limit

02/19/2026: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Note: The information contained in this article is only a summary of revisions to the LCDs and/or PAs. For complete information on any topic, you must review the LCDs and/or PAs.