MyMedi-AI

E0186 — Air 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
Capped rental
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). 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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

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

E0186 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $22.53 to $59.47 depending on state and rural status.

StateNon-ruralRural
AK$52.59
AL$22.53$24.59
AR$22.53$24.59
AZ$22.95$27.24
CA$23.90$27.24
CO$22.60$27.24
CT$24.06$27.24
DC$23.75$27.24
DE$23.75$27.24
FL$22.53$27.24
GA$22.53$24.59
HI$54.50
IA$22.90$26.36
ID$22.60$27.24
IL$24.04$24.59
IN$24.04$24.59
KS$22.90$24.59
KY$22.53$24.59
LA$22.53$24.87
MA$24.06$24.59
MD$23.75$27.24
ME$24.06$24.59
MI$24.04$27.24
MN$22.90$24.59
MO$22.90$27.24
MS$22.53$24.59
MT$22.60$24.59
NC$22.53$24.59
ND$22.90$27.24
NE$22.90$24.59
NH$24.06$24.59
NJ$23.75$27.24
NM$22.95$24.59
NV$23.90$27.24
NY$23.75$27.24
OH$24.04$27.24
OK$22.95$24.59
OR$23.90$27.24
PA$23.75$27.24
PR$59.47
RI$24.06$26.03
SC$22.53$24.59
SD$22.90$27.24
TN$22.53$24.59
TX$22.95$27.24
UT$22.60$24.59
VA$22.53$27.24
VI$28.93
VT$24.06$24.59
WA$23.90$27.24
WI$24.04$27.24
WV$22.53$27.24
WY$22.60$27.24
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

Common denial codes to watch

Related E-codes

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