MyMedi-AI

E0640 — Patient lift, fixed system, includes all components/accessories

HCPCS Level II E-code · short descriptor: “Fixed patient lift system”

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.

E0640 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $135.13 to $218.07 depending on state and rural status.

Former-CBA payment limits: ceiling $158.98 · floor $135.13

StateNon-ruralRural
AK$158.91—
AL$135.13—
AR$158.98—
AZ$158.98—
CA$157.34—
CO$158.98—
CT$136.43—
DC$135.13—
DE$135.13—
FL$135.13—
GA$156.56—
HI$169.92—
IA$146.59—
ID$158.98—
IL$158.98—
IN$158.98—
KS$156.99—
KY$158.98—
LA$158.98—
MA$158.98—
MD$135.13—
ME$158.98—
MI$158.98—
MN$135.13—
MO$145.70—
MS$158.98—
MT$158.98—
NC$158.98—
ND$158.98—
NE$158.98—
NH$158.98—
NJ$135.13—
NM$157.82—
NV$158.98—
NY$154.37—
OH$141.64—
OK$158.98—
OR$153.01—
PA$143.39—
PR$218.07—
RI$135.21—
SC$158.98—
SD$158.98—
TN$158.98—
TX$158.98—
UT$136.50—
VA$135.13—
VI$154.34—
VT$158.98—
WA$152.67—
WI$137.61—
WV$135.13—
WY$158.98—
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 E0640 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 E0640 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.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, E0640 included, and starter credits via POST /bot-marketplace/register.