E0196 — Gel 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
- 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.
E0196 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $37.71 to $58.06 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $51.17 | — |
| AL | $37.71 | $44.79 |
| AR | $37.71 | $39.35 |
| AZ | $39.10 | $39.35 |
| CA | $38.74 | $44.79 |
| CO | $39.14 | $44.79 |
| CT | $40.39 | $44.79 |
| DC | $39.60 | $44.79 |
| DE | $39.60 | $44.40 |
| FL | $37.71 | $44.79 |
| GA | $37.71 | $39.35 |
| HI | $53.08 | — |
| IA | $39.35 | $39.35 |
| ID | $39.14 | $39.35 |
| IL | $42.18 | $44.79 |
| IN | $42.18 | $44.79 |
| KS | $39.69 | $44.79 |
| KY | $37.71 | $39.35 |
| LA | $37.71 | $39.35 |
| MA | $39.35 | $39.35 |
| MD | $39.60 | $44.79 |
| ME | $39.35 | $39.35 |
| MI | $42.18 | $44.79 |
| MN | $39.35 | $39.35 |
| MO | $39.69 | $44.50 |
| MS | $37.71 | $39.35 |
| MT | $39.14 | $39.35 |
| NC | $37.71 | $44.79 |
| ND | $39.69 | $44.79 |
| NE | $39.69 | $44.79 |
| NH | $39.35 | $39.35 |
| NJ | $39.35 | $39.35 |
| NM | $39.10 | $41.92 |
| NV | $38.74 | $39.35 |
| NY | $39.60 | $44.79 |
| OH | $42.18 | $44.79 |
| OK | $39.10 | $44.79 |
| OR | $38.74 | $44.79 |
| PA | $39.60 | $44.79 |
| PR | $58.06 | — |
| RI | $39.35 | $39.35 |
| SC | $37.71 | $39.35 |
| SD | $39.69 | $44.79 |
| TN | $37.71 | $39.35 |
| TX | $39.10 | $44.79 |
| UT | $39.14 | $44.79 |
| VA | $37.71 | $44.79 |
| VI | $46.30 | — |
| VT | $39.35 | $39.35 |
| WA | $38.74 | $44.79 |
| WI | $42.18 | $43.45 |
| WV | $37.71 | $44.14 |
| WY | $39.14 | $44.79 |
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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