MyMedi-AI

E0194 — Air fluidized bed

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
Required from 2026-10-28 (Medicare)
Face-to-face & WOPD
Required from 2026-10-28 (Pressure Reducing Support Surfaces)
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

PA STARTS 2026-10-28 E0194 joins Medicare's DMEPOS Required Prior Authorization List for dates of service on or after 2026-10-28 (Pressure Reducing Support Surfaces — CMS-6109-N, 91 FR 47972 (published 2026-07-30)).

Claims for this item without an affirmed prior-authorization decision are automatically denied (commonly surfacing as CO-197). Submit the PA request to your DME MAC with the order and supporting clinical documentation 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))

F2F + WOPD FROM 2026-10-28 E0194 joins Medicare's Required Face-to-Face & WOPD List for dates of service on or after 2026-10-28 (Pressure Reducing Support Surfaces — CMS-6109-N, 91 FR 47972 (published 2026-07-30)). From that date two extra conditions of payment apply:

  • Face-to-face encounter (in-person or telehealth) with the treating practitioner within the 6 months before the order date
  • Written order communicated to the supplier before delivery (WOPD)

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

E0194 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $3856.78 to $4884.31 depending on state and rural status.

Former-CBA payment limits: ceiling $4637.87 · floor $3942.19

StateNon-ruralRural
AK$4567.74—
AL$4637.87—
AR$4637.87—
AZ$4637.87—
CA$4522.54—
CO$4637.87—
CT$4637.87—
DC$4637.87—
DE$4637.87—
FL$4091.01—
GA$3942.19—
HI$4884.31—
IA$4637.87—
ID$4637.87—
IL$4637.87—
IN$4637.87—
KS$4637.87—
KY$3942.19—
LA$4637.87—
MA$4637.87—
MD$3993.91—
ME$4637.87—
MI$4372.12—
MN$3942.19—
MO$4637.87—
MS$4637.87—
MT$4637.87—
NC$4054.55—
ND$4637.69—
NE$4637.87—
NH$4637.87—
NJ$4489.00—
NM$3942.19—
NV$4637.87—
NY$3942.19—
OH$4242.32—
OK$4205.57—
OR$3942.19—
PA$4584.57—
PR$3856.78—
RI$4333.81—
SC$3942.19—
SD$4637.87—
TN$4101.52—
TX$4226.58—
UT$4637.87—
VA$3942.19—
VI$3942.19—
VT$4637.87—
WA$4134.43—
WI$3942.19—
WV$4048.89—
WY$4637.87—
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 E0194 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

Bill E0194 with confidence

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