MyMedi-AI

E0316 — Safety enclosure frame/canopy for use with hospital bed, any type

HCPCS Level II E-code · short descriptor: “Bed safety enclosure”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
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 2026-10-25; 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))

Not on the F2F/WOPD list (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)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

E0316 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $182.59 to $286.86 depending on state and rural status.

StateNon-ruralRural
AK$286.86—
AL$259.52$259.52
AR$238.87$238.87
AZ$220.59$220.59
CA$249.56$249.56
CO$244.56$244.56
CT$259.52$259.52
DC$255.17$259.52
DE$255.17$259.52
FL$259.52$259.52
GA$259.52$259.52
HI$233.95—
IA$259.52$259.52
ID$247.24$247.24
IL$238.69$238.69
IN$257.75$259.52
KS$259.52$259.52
KY$259.52$259.52
LA$239.22$239.22
MA$259.52$259.52
MD$253.22$253.22
ME$259.52$259.52
MI$240.40$240.40
MN$259.52$259.52
MO$259.52$259.52
MS$251.66$251.66
MT$235.76$235.76
NC$259.52$259.52
ND$237.52$237.52
NE$259.52$259.52
NH$259.52$259.52
NJ$255.17$259.52
NM$233.96$233.96
NV$228.48$228.48
NY$255.17$259.52
OH$243.80$243.80
OK$248.10$248.10
OR$247.78$247.78
PA$255.17$259.52
PR$182.59—
RI$259.52$259.52
SC$259.52$259.52
SD$247.46$247.46
TN$251.16$251.16
TX$237.03$237.03
UT$252.54$259.52
VA$257.88$257.88
VI$239.06—
VT$259.52$259.52
WA$249.45$249.45
WI$251.05$251.05
WV$259.52$259.52
WY$249.87$249.87
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 E0316 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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