MyMedi-AI

E0372 — Powered air overlay for mattress, standard mattress length and width

HCPCS Level II E-code · short descriptor: “Powered air mattress overlay” · PA required

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
Required (Medicare, since 2019-10-21)
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

PA REQUIRED E0372 is on Medicare's DMEPOS Required Prior Authorization List (Pressure Reducing Support Surfaces — nationwide since 2019-10-21).

Claims for this item without an affirmed prior-authorization decision are automatically denied (commonly surfacing as CO-197). Submit the PA request to your DME MAC with the order and supporting clinical documentation 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.

E0372 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $185.56 to $519.97 depending on state and rural status.

StateNon-ruralRural
AK$511.75—
AL$251.55$455.87
AR$251.55$462.75
AZ$256.63$438.94
CA$185.56$447.06
CO$249.97$462.75
CT$234.53$462.75
DC$219.86$462.75
DE$219.86$454.85
FL$251.55$434.72
GA$251.55$452.80
HI$468.16—
IA$257.64$462.75
ID$249.97$462.75
IL$230.02$462.75
IN$230.02$462.75
KS$257.64$462.75
KY$251.55$462.75
LA$251.55$456.89
MA$234.53$462.75
MD$219.86$443.97
ME$234.53$462.75
MI$230.02$448.28
MN$257.64$462.75
MO$257.64$462.75
MS$251.55$428.34
MT$249.97$430.19
NC$251.55$462.75
ND$257.64$429.78
NE$257.64$462.75
NH$234.53$462.75
NJ$219.86$442.34
NM$256.63$424.32
NV$185.56$446.36
NY$219.86$452.71
OH$230.02$462.75
OK$256.63$462.75
OR$185.56$462.75
PA$219.86$448.96
PR$519.97—
RI$234.53$413.06
SC$251.55$450.49
SD$257.64$456.35
TN$251.55$442.04
TX$256.63$462.75
UT$249.97$462.75
VA$251.55$444.24
VI$462.75—
VT$234.53$462.75
WA$185.56$462.75
WI$230.02$462.75
WV$251.55$451.56
WY$249.97$455.35
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 E0372 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 E0372 with confidence

Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.

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