MyMedi-AI

E0184 — Dry pressure mattress

HCPCS Level II E-code

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Inexpensive or routinely purchased
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.

E0184 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $150.13 to $274.63 depending on state and rural status.

StateNon-ruralRural
AK$150.13—
AL$202.16$227.82
AR$202.16$248.63
AZ$190.07$227.82
CA$196.24$227.82
CO$211.28$227.82
CT$200.35$248.63
DC$191.73$248.63
DE$191.73$248.63
FL$202.16$248.63
GA$202.16$248.63
HI$160.52—
IA$205.36$234.22
ID$211.28$248.63
IL$194.60$227.82
IN$194.60$248.63
KS$205.36$247.08
KY$202.16$227.82
LA$202.16$248.63
MA$200.35$248.63
MD$191.73$248.63
ME$200.35$248.63
MI$194.60$227.82
MN$205.36$227.82
MO$205.36$248.63
MS$202.16$248.63
MT$211.28$227.82
NC$202.16$248.63
ND$205.36$227.82
NE$205.36$248.63
NH$200.35$248.63
NJ$191.73$227.82
NM$190.07$227.82
NV$196.24$227.82
NY$191.73$248.63
OH$194.60$227.82
OK$190.07$227.82
OR$196.24$237.02
PA$191.73$248.63
PR$274.63—
RI$200.35$248.63
SC$202.16$248.63
SD$205.36$227.82
TN$202.16$248.63
TX$190.07$227.82
UT$211.28$227.82
VA$202.16$248.63
VI$248.63—
VT$200.35$248.63
WA$196.24$248.63
WI$194.60$244.55
WV$202.16$227.82
WY$211.28$227.82

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $19.01 to $46.61 depending on state and rural status.

StateNon-ruralRural
AK$44.31—
AL$20.22$28.50
AR$20.22$25.87
AZ$19.01$25.87
CA$19.62$28.50
CO$21.13$25.87
CT$20.04$28.50
DC$19.17$28.50
DE$19.17$28.50
FL$20.22$28.50
GA$20.22$27.09
HI$46.61—
IA$20.54$25.87
ID$21.13$28.36
IL$19.46$28.50
IN$19.46$28.50
KS$20.54$28.50
KY$20.22$25.87
LA$20.22$25.87
MA$20.04$27.94
MD$19.17$28.50
ME$20.04$27.94
MI$19.46$25.87
MN$20.54$25.87
MO$20.54$28.50
MS$20.22$28.50
MT$21.13$25.87
NC$20.22$28.50
ND$20.54$25.87
NE$20.54$28.50
NH$20.04$27.94
NJ$19.17$28.50
NM$19.01$25.87
NV$19.62$25.87
NY$19.17$28.50
OH$19.46$28.50
OK$19.01$25.87
OR$19.62$25.87
PA$19.17$28.50
PR$31.58—
RI$20.04$28.50
SC$20.22$28.50
SD$20.54$25.87
TN$20.22$28.50
TX$19.01$28.50
UT$21.13$25.87
VA$20.22$27.27
VI$28.50—
VT$20.04$27.94
WA$19.62$28.50
WI$19.46$25.87
WV$20.22$28.50
WY$21.13$28.50

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $121.30 to $205.98 depending on state and rural status.

StateNon-ruralRural
AK$121.30—
AL$151.62$172.86
AR$151.62$186.48
AZ$142.55$172.86
CA$147.19$172.86
CO$158.46$172.86
CT$150.27$188.82
DC$143.80$188.82
DE$143.80$188.82
FL$151.62$188.82
GA$151.62$188.82
HI$129.71—
IA$154.02$175.66
ID$158.46$188.82
IL$145.95$172.86
IN$145.95$188.82
KS$154.02$185.31
KY$151.62$172.86
LA$151.62$188.82
MA$150.27$188.82
MD$143.80$188.82
ME$150.27$188.82
MI$145.95$172.86
MN$154.02$172.86
MO$154.02$188.82
MS$151.62$188.82
MT$158.46$172.86
NC$151.62$188.82
ND$154.02$172.86
NE$154.02$188.82
NH$150.27$188.82
NJ$143.80$172.86
NM$142.55$172.86
NV$147.19$172.86
NY$143.80$188.82
OH$145.95$172.86
OK$142.55$172.86
OR$147.19$177.78
PA$143.80$188.82
PR$205.98—
RI$150.27$188.82
SC$151.62$188.82
SD$154.02$172.86
TN$151.62$188.82
TX$142.55$172.86
UT$158.46$172.86
VA$151.62$188.82
VI$188.82—
VT$150.27$188.82
WA$147.19$188.82
WI$145.95$183.41
WV$151.62$188.82
WY$158.46$172.86
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 E0184 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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