E0255 HCPCS code: Hospital bed, variable height, hi-lo, with any type side rails, with mattress
E0255 is the HCPCS Level II code for hospital bed, variable height, hi-lo, with any type side rails, with mattress. The 2026 Medicare DMEPOS fee schedule pays $72.80 to $144.83 (RR, rental (monthly)) depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume fell 32% from 2022 to 2024 (19,650 to 13,347 services). In 2024, 225 suppliers billed Medicare for E0255 (rentals), serving 2,752 beneficiaries; Ohio, Maryland, Michigan accounted for 50% of services. Its average fee ranks 25 of 34 E02 codes billed RR (family range $1.55–$263.61); rural fees run 40% higher.
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 36 — DMEPOS: capped rental item |
| BETOS category | D1B — Hospital beds |
| Added | 1986-01-01 |
| Last action effective | 1991-01-01 |
2026 Medicare DMEPOS fee schedule for E0255
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $72.80 | $144.83 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $105.85 | — |
| AL | RR | $77.94 | $103.17 |
| AR | RR | $77.94 | $113.99 |
| AZ | RR | $77.50 | $113.99 |
| CA | RR | $74.66 | $105.21 |
| CO | RR | $76.76 | $113.99 |
| CT | RR | $72.80 | $113.99 |
| DC | RR | $74.43 | $110.40 |
| DE | RR | $74.43 | $113.99 |
| FL | RR | $77.94 | $110.80 |
| GA | RR | $77.94 | $103.68 |
| HI | RR | $110.28 | — |
| IA | RR | $76.74 | $113.99 |
| ID | RR | $76.76 | $103.17 |
| IL | RR | $75.89 | $113.99 |
| IN | RR | $75.89 | $106.14 |
| KS | RR | $76.74 | $113.01 |
| KY | RR | $77.94 | $103.65 |
| LA | RR | $77.94 | $109.32 |
| MA | RR | $72.80 | $113.99 |
| MD | RR | $74.43 | $113.99 |
| ME | RR | $72.80 | $113.99 |
| MI | RR | $75.89 | $113.99 |
| MN | RR | $76.74 | $113.99 |
| MO | RR | $76.74 | $103.17 |
| MS | RR | $77.94 | $103.17 |
| MT | RR | $76.76 | $112.98 |
| NC | RR | $77.94 | $106.57 |
| ND | RR | $76.74 | $112.83 |
| NE | RR | $76.74 | $113.99 |
| NH | RR | $72.80 | $113.99 |
| NJ | RR | $74.43 | $104.23 |
| NM | RR | $77.50 | $107.48 |
| NV | RR | $74.66 | $113.99 |
| NY | RR | $74.43 | $113.99 |
| OH | RR | $75.89 | $113.99 |
| OK | RR | $77.50 | $113.99 |
| OR | RR | $74.66 | $113.99 |
| PA | RR | $74.43 | $112.09 |
| PR | RR | $144.83 | — |
| RI | RR | $72.80 | $103.17 |
| SC | RR | $77.94 | $103.17 |
| SD | RR | $76.74 | $111.25 |
| TN | RR | $77.94 | $109.00 |
| TX | RR | $77.50 | $113.99 |
| UT | RR | $76.76 | $105.30 |
| VA | RR | $77.94 | $113.99 |
| VI | RR | $113.99 | — |
| VT | RR | $72.80 | $113.99 |
| WA | RR | $74.66 | $113.99 |
| WI | RR | $75.89 | $113.99 |
| WV | RR | $77.94 | $113.99 |
| WY | RR | $76.76 | $108.05 |
How the E0255 fee compares
| Measure | Value |
|---|---|
| Rank among 34 E02 codes billed RR (lowest = 1) | 25 |
| Family fee range (average of state fees) | $1.55–$263.61 |
| Rural fee uplift | 39.5% |
Who bills E0255 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | 225 |
| Suppliers billing purchases | — |
| Referring clinicians | 2,050 |
| Medicare beneficiaries | 2,752 |
| States with claims | 39 |
| Share of services in top 3 states (Ohio, Maryland, Michigan) | 50% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 242 | 4,208 |
| 2023 | 224 | 3,769 |
| 2024 | 225 | 2,752 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0255, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 19,650 | 4,208 | $63.17 | $45.49 |
| 2023 | 17,959 | 3,769 | $68.05 | $49.49 |
| 2024 | 13,347 | 2,752 | $67.67 | $48.66 |
States with the most E0255 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 3,448 | $49.11 |
| Maryland | 1,783 | $44.72 |
| Michigan | 1,449 | $47.05 |
| Mississippi | 1,022 | $53.32 |
| Illinois | 808 | $50.51 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A52508: Hospital Beds And Accessories - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for E0255
- 2026-01-01: Average state fee (RR) rose 2.6%: $77.25 to $79.30
- 1986-01-01: E0255 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code E0255?
E0255 is the HCPCS Level II code for hospital bed, variable height, hi-lo, with any type side rails, with mattress. Short descriptor: "Hospital bed var ht w/ mattr".
How much does Medicare pay for E0255?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $72.80–$144.83. Rural fees can be higher.
Does Medicare cover E0255?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E0255 change in 2026?
The average non-rural state fee for RR moved from $77.25 in 2025 to $79.30 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0255 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E02 codes
- E0200 — Heat lamp, without stand (table model), includes bulb, or infrared element ($13.04–$237.31)
- E0201 — Penile contracture device, manual, greater than 3 lbs traction force ($14.65–$146.52)
- E0202 — Phototherapy (bilirubin) light with photometer ($75.19–$320.58)
- E0203 — Therapeutic lightbox, minimum 10,000 lux, table top model
- E0205 — Heat lamp, with stand, includes bulb, or infrared element ($25.87–$370.65)
- E0210 — Electric heat pad, standard ($3.73–$127.76)
- E0215 — Electric heat pad, moist ($8.98–$155.37)
- E0217 — Water circulating heat pad with pump ($66.95–$923.22)
- E0218 — Fluid circulating cold pad with pump, any type
- E0221 — Infrared heating pad system
- E0225 — Hydrocollator unit, includes pads ($46.40–$682.90)
- E0231 — Non-contact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under E0255
- Watch E0255 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0255
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.