E0197 — Air pressure pad for mattress, standard mattress length and width
HCPCS Level II E-code · short descriptor: “Air pressure pad for mattres”
- 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.
E0197 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $20.93 to $73.25 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $69.94 | — |
| AL | $21.12 | $30.91 |
| AR | $21.12 | $30.91 |
| AZ | $21.58 | $30.91 |
| CA | $21.61 | $34.17 |
| CO | $23.02 | $34.17 |
| CT | $23.59 | $30.91 |
| DC | $22.72 | $34.17 |
| DE | $22.72 | $34.17 |
| FL | $21.12 | $30.91 |
| GA | $21.12 | $30.91 |
| HI | $73.25 | — |
| IA | $23.93 | $34.17 |
| ID | $23.02 | $34.17 |
| IL | $23.50 | $31.91 |
| IN | $23.50 | $30.91 |
| KS | $23.93 | $34.17 |
| KY | $21.12 | $30.91 |
| LA | $21.12 | $30.91 |
| MA | $23.59 | $30.91 |
| MD | $22.72 | $34.17 |
| ME | $23.59 | $30.91 |
| MI | $23.50 | $34.17 |
| MN | $23.93 | $34.17 |
| MO | $23.93 | $34.17 |
| MS | $21.12 | $30.91 |
| MT | $23.02 | $34.17 |
| NC | $21.12 | $30.91 |
| ND | $23.93 | $34.17 |
| NE | $23.93 | $34.17 |
| NH | $23.59 | $30.91 |
| NJ | $22.72 | $34.17 |
| NM | $21.58 | $30.91 |
| NV | $21.61 | $30.91 |
| NY | $22.72 | $30.91 |
| OH | $23.50 | $34.17 |
| OK | $21.58 | $30.91 |
| OR | $21.61 | $34.17 |
| PA | $22.72 | $34.17 |
| PR | $20.93 | — |
| RI | $23.59 | $34.17 |
| SC | $21.12 | $30.91 |
| SD | $23.93 | $31.65 |
| TN | $21.12 | $30.91 |
| TX | $21.58 | $30.91 |
| UT | $23.02 | $34.17 |
| VA | $21.12 | $34.17 |
| VI | $37.03 | — |
| VT | $23.59 | $30.91 |
| WA | $21.61 | $34.17 |
| WI | $23.50 | $34.17 |
| WV | $21.12 | $34.17 |
| WY | $23.02 | $34.17 |
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
Bill E0197 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →