MyMedi-AI

E0290 — Hospital bed, fixed height, without side rails, with mattress

HCPCS Level II E-code · short descriptor: “Hosp bed fx ht w/o rails w/m”

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
Required (Hospital beds)
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 2026-10-25; 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))

F2F + WOPD REQUIRED E0290 is on Medicare's Required Face-to-Face & WOPD List (Hospital beds — CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). 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.

E0290 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $63.75 to $100.24 depending on state and rural status.

StateNon-ruralRural
AK$63.75—
AL$70.60$77.97
AR$70.60$83.46
AZ$72.77$84.85
CA$66.06$77.97
CO$72.51$84.85
CT$71.06$84.85
DC$69.43$77.97
DE$69.43$84.85
FL$70.60$84.85
GA$70.60$77.97
HI$68.17—
IA$71.73$84.85
ID$72.51$81.61
IL$71.97$84.85
IN$71.97$84.85
KS$71.73$84.85
KY$70.60$77.97
LA$70.60$84.85
MA$71.06$84.85
MD$69.43$84.85
ME$71.06$84.85
MI$71.97$84.71
MN$71.73$77.97
MO$71.73$77.97
MS$70.60$77.97
MT$72.51$83.82
NC$70.60$79.36
ND$71.73$84.85
NE$71.73$80.83
NH$71.06$84.85
NJ$69.43$77.97
NM$72.77$77.97
NV$66.06$84.85
NY$69.43$84.18
OH$71.97$77.97
OK$72.77$84.85
OR$66.06$77.97
PA$69.43$84.85
PR$100.24—
RI$71.06$84.85
SC$70.60$78.97
SD$71.73$84.85
TN$70.60$77.97
TX$72.77$84.85
UT$72.51$84.85
VA$70.60$77.97
VI$84.18—
VT$71.06$84.85
WA$66.06$84.85
WI$71.97$77.97
WV$70.60$77.97
WY$72.51$84.85
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 E0290 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 E0290 with confidence

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