MyMedi-AI

E0181 — Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty

HCPCS Level II E-code · short descriptor: “Press pad alternating w/ pum”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Capped rental
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

E0181 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $17.94 to $36.69 depending on state and rural status.

StateNon-ruralRural
AK$36.69—
AL$19.77$29.19
AR$19.77$29.19
AZ$19.84$29.19
CA$19.37$29.19
CO$20.76$29.19
CT$18.02$29.19
DC$17.94$29.19
DE$17.94$29.19
FL$19.77$29.19
GA$19.77$29.19
HI$34.14—
IA$19.48$29.19
ID$20.76$29.19
IL$19.29$29.19
IN$19.29$29.19
KS$19.48$29.19
KY$19.77$29.19
LA$19.77$29.19
MA$18.02$29.19
MD$17.94$28.02
ME$18.02$29.19
MI$19.29$29.19
MN$19.48$29.19
MO$19.48$29.19
MS$19.77$29.19
MT$20.76$29.19
NC$19.77$29.19
ND$19.48$29.19
NE$19.48$29.19
NH$18.02$29.19
NJ$17.94$29.19
NM$19.84$29.19
NV$19.37$29.19
NY$17.94$29.19
OH$19.29$29.19
OK$19.84$29.19
OR$19.37$29.19
PA$17.94$29.19
PR$36.37—
RI$18.02$29.19
SC$19.77$29.19
SD$19.48$29.19
TN$19.77$29.19
TX$19.84$29.19
UT$20.76$29.19
VA$19.77$29.19
VI$32.65—
VT$18.02$29.19
WA$19.37$29.19
WI$19.29$29.19
WV$19.77$29.19
WY$20.76$29.19
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps E0181 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related E-codes

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