E0256 HCPCS code: Hospital bed, variable height, hi-lo, with any type side rails, without mattress
E0256 is the HCPCS Level II code for hospital bed, variable height, hi-lo, with any type side rails, without mattress. The 2026 Medicare DMEPOS fee schedule pays $71.35 to $117.40 (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 72% from 2022 to 2024 (2,640 to 735 services). In 2024, 51 suppliers billed Medicare for E0256 (rentals), serving 155 beneficiaries; Maryland, Michigan, Mississippi accounted for 49% of services. Its average fee ranks 21 of 34 E02 codes billed RR (family range $1.55–$263.61); rural fees run 19% 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 | 1991-01-01 |
| Last action effective | 1991-01-01 |
2026 Medicare DMEPOS fee schedule for E0256
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $71.35 | $117.40 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $82.89 | — |
| AL | RR | $74.17 | $84.13 |
| AR | RR | $74.17 | $91.81 |
| AZ | RR | $75.80 | $91.57 |
| CA | RR | $71.35 | $84.13 |
| CO | RR | $76.76 | $91.81 |
| CT | RR | $72.80 | $91.81 |
| DC | RR | $71.87 | $89.47 |
| DE | RR | $71.87 | $88.80 |
| FL | RR | $74.17 | $89.07 |
| GA | RR | $74.17 | $84.13 |
| HI | RR | $85.84 | — |
| IA | RR | $74.42 | $91.81 |
| ID | RR | $76.76 | $87.38 |
| IL | RR | $73.40 | $91.81 |
| IN | RR | $73.40 | $91.02 |
| KS | RR | $74.42 | $91.81 |
| KY | RR | $74.17 | $84.13 |
| LA | RR | $74.17 | $91.81 |
| MA | RR | $72.80 | $91.81 |
| MD | RR | $71.87 | $91.04 |
| ME | RR | $72.80 | $91.81 |
| MI | RR | $73.40 | $91.81 |
| MN | RR | $74.42 | $87.38 |
| MO | RR | $74.42 | $84.13 |
| MS | RR | $74.17 | $84.13 |
| MT | RR | $76.76 | $91.81 |
| NC | RR | $74.17 | $89.49 |
| ND | RR | $74.42 | $91.81 |
| NE | RR | $74.42 | $90.36 |
| NH | RR | $72.80 | $91.81 |
| NJ | RR | $71.87 | $84.13 |
| NM | RR | $75.80 | $91.81 |
| NV | RR | $71.35 | $91.81 |
| NY | RR | $71.87 | $91.81 |
| OH | RR | $73.40 | $84.24 |
| OK | RR | $75.80 | $91.81 |
| OR | RR | $71.35 | $91.81 |
| PA | RR | $71.87 | $88.57 |
| PR | RR | $117.40 | — |
| RI | RR | $72.80 | $91.81 |
| SC | RR | $74.17 | $84.13 |
| SD | RR | $74.42 | $91.81 |
| TN | RR | $74.17 | $84.13 |
| TX | RR | $75.80 | $91.81 |
| UT | RR | $76.76 | $91.81 |
| VA | RR | $74.17 | $84.13 |
| VI | RR | $91.81 | — |
| VT | RR | $72.80 | $91.81 |
| WA | RR | $71.35 | $91.81 |
| WI | RR | $73.40 | $89.78 |
| WV | RR | $74.17 | $84.13 |
| WY | RR | $76.76 | $91.81 |
How the E0256 fee compares
| Measure | Value |
|---|---|
| Rank among 34 E02 codes billed RR (lowest = 1) | 21 |
| Family fee range (average of state fees) | $1.55–$263.61 |
| Rural fee uplift | 18.5% |
Who bills E0256 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | 51 |
| Suppliers billing purchases | — |
| Referring clinicians | 147 |
| Medicare beneficiaries | 155 |
| States with claims | 12 |
| Share of services in top 3 states (Maryland, Michigan, Mississippi) | 49% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 70 | 533 |
| 2023 | 66 | 319 |
| 2024 | 51 | 155 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0256, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,640 | 533 | $52.55 | $38.47 |
| 2023 | 1,702 | 319 | $54.18 | $38.70 |
| 2024 | 735 | 155 | $57.45 | $42.30 |
States with the most E0256 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Maryland | 161 | $44.08 |
| Michigan | 83 | $46.76 |
| Mississippi | 70 | $42.53 |
| Ohio | 67 | $42.88 |
| New York | 61 | $38.18 |
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 E0256
- 2026-01-01: Average state fee (RR) rose 2.7%: $73.45 to $75.40
- 1991-01-01: E0256 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 E0256?
E0256 is the HCPCS Level II code for hospital bed, variable height, hi-lo, with any type side rails, without mattress. Short descriptor: "Hospital bed var ht w/o matt".
How much does Medicare pay for E0256?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $71.35–$117.40. Rural fees can be higher.
Does Medicare cover E0256?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E0256 change in 2026?
The average non-rural state fee for RR moved from $73.45 in 2025 to $75.40 in 2026 (+2.7%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0256 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 E0256
- Watch E0256 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0256
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.