MyMedi-AI

E0256 — Hospital bed, variable height, hi-lo, with any type side rails, without mattress

HCPCS Level II E-code · short descriptor: “Hospital bed var ht w/o matt”

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
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 2026-10-26; 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 2026-10-26; 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.

E0256 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $71.35 to $117.40 depending on state and rural status.

StateNon-ruralRural
AK$82.89—
AL$74.17$84.13
AR$74.17$91.81
AZ$75.80$91.57
CA$71.35$84.13
CO$76.76$91.81
CT$72.80$91.81
DC$71.87$89.47
DE$71.87$88.80
FL$74.17$89.07
GA$74.17$84.13
HI$85.84—
IA$74.42$91.81
ID$76.76$87.38
IL$73.40$91.81
IN$73.40$91.02
KS$74.42$91.81
KY$74.17$84.13
LA$74.17$91.81
MA$72.80$91.81
MD$71.87$91.04
ME$72.80$91.81
MI$73.40$91.81
MN$74.42$87.38
MO$74.42$84.13
MS$74.17$84.13
MT$76.76$91.81
NC$74.17$89.49
ND$74.42$91.81
NE$74.42$90.36
NH$72.80$91.81
NJ$71.87$84.13
NM$75.80$91.81
NV$71.35$91.81
NY$71.87$91.81
OH$73.40$84.24
OK$75.80$91.81
OR$71.35$91.81
PA$71.87$88.57
PR$117.40—
RI$72.80$91.81
SC$74.17$84.13
SD$74.42$91.81
TN$74.17$84.13
TX$75.80$91.81
UT$76.76$91.81
VA$74.17$84.13
VI$91.81—
VT$72.80$91.81
WA$71.35$91.81
WI$73.40$89.78
WV$74.17$84.13
WY$76.76$91.81
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 E0256 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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