MyMedi-AI

E0304 — Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress

HCPCS Level II E-code · short descriptor: “Hosp bed xtra hvy dty x wide”

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 E0304 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.

E0304 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $573.26 to $898.22 depending on state and rural status.

StateNon-ruralRural
AK$803.56—
AL$627.10$803.56
AR$627.10$803.56
AZ$595.97$803.56
CA$573.26$803.56
CO$594.89$803.56
CT$595.34$803.56
DC$578.37$803.56
DE$578.37$803.56
FL$627.10$803.56
GA$627.10$803.56
HI$803.56—
IA$594.30$803.56
ID$594.89$803.56
IL$608.58$803.56
IN$608.58$803.56
KS$594.30$732.57
KY$627.10$803.56
LA$627.10$803.56
MA$595.34$803.56
MD$578.37$803.56
ME$595.34$803.56
MI$608.58$803.56
MN$594.30$803.56
MO$594.30$803.56
MS$627.10$803.56
MT$594.89$803.56
NC$627.10$803.56
ND$594.30$803.56
NE$594.30$803.56
NH$595.34$803.56
NJ$578.37$803.56
NM$595.97$803.56
NV$573.26$803.56
NY$578.37$803.56
OH$608.58$803.56
OK$595.97$803.56
OR$573.26$803.56
PA$578.37$803.56
PR$898.22—
RI$595.34$803.56
SC$627.10$803.56
SD$594.30$803.56
TN$627.10$803.56
TX$595.97$803.56
UT$594.89$803.56
VA$627.10$803.56
VI$803.56—
VT$595.34$803.56
WA$573.26$803.56
WI$608.58$803.56
WV$627.10$803.56
WY$594.89$803.56
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 E0304 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 E0304 with confidence

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