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E0265 — Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress

HCPCS Level II E-code · short descriptor: “Hosp bed total electr w/ mat”

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.

E0265 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $184.01 to $267.38 depending on state and rural status.

StateNon-ruralRural
AK$215.80
AL$184.01$196.36
AR$184.01$214.77
AZ$184.01$214.77
CA$184.01$214.56
CO$184.01$214.77
CT$184.01$211.02
DC$184.01$214.77
DE$184.01$214.77
FL$184.01$196.36
GA$184.01$196.36
HI$224.39
IA$184.01$214.77
ID$184.01$214.77
IL$184.01$214.77
IN$184.01$211.44
KS$184.01$214.77
KY$184.01$201.09
LA$184.01$214.77
MA$184.01$214.77
MD$184.01$211.51
ME$184.01$214.77
MI$184.01$205.39
MN$184.01$197.81
MO$184.01$197.67
MS$184.01$206.27
MT$184.01$214.77
NC$184.01$214.77
ND$184.01$214.77
NE$184.01$207.32
NH$184.01$211.53
NJ$184.01$210.00
NM$184.01$206.04
NV$184.01$196.36
NY$184.01$214.77
OH$184.01$214.77
OK$184.01$205.30
OR$184.01$214.77
PA$184.01$214.77
PR$267.38
RI$184.01$196.36
SC$184.01$196.36
SD$184.01$214.77
TN$184.01$202.45
TX$184.01$214.77
UT$184.01$212.72
VA$184.01$214.77
VI$214.77
VT$184.01$214.77
WA$184.01$214.77
WI$184.01$212.93
WV$184.01$201.48
WY$184.01$214.77
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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