E0261 HCPCS code: Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress
E0261 is the HCPCS Level II code for hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress. The 2026 Medicare DMEPOS fee schedule pays $72.80 to $161.23 (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 2% from 2022 to 2024 (125,547 to 122,881 services). In 2024, 1,591 suppliers billed Medicare for E0261 (rentals), serving 25,848 beneficiaries; New York, California, Florida accounted for 31% of services. Its average fee ranks 28 of 34 E02 codes billed RR (family range $1.55–$263.61); rural fees run 50% 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 E0261
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $72.80 | $161.23 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $120.78 | — |
| AL | RR | $77.86 | $113.32 |
| AR | RR | $77.86 | $125.94 |
| AZ | RR | $77.50 | $125.94 |
| CA | RR | $74.66 | $120.00 |
| CO | RR | $76.76 | $125.94 |
| CT | RR | $72.80 | $125.94 |
| DC | RR | $74.43 | $115.74 |
| DE | RR | $74.43 | $125.94 |
| FL | RR | $77.86 | $113.32 |
| GA | RR | $77.86 | $113.32 |
| HI | RR | $126.24 | — |
| IA | RR | $76.74 | $125.94 |
| ID | RR | $76.76 | $125.94 |
| IL | RR | $75.89 | $125.94 |
| IN | RR | $75.89 | $119.70 |
| KS | RR | $76.74 | $117.13 |
| KY | RR | $77.86 | $113.32 |
| LA | RR | $77.86 | $125.94 |
| MA | RR | $72.80 | $125.94 |
| MD | RR | $74.43 | $115.39 |
| ME | RR | $72.80 | $125.94 |
| MI | RR | $75.89 | $125.94 |
| MN | RR | $76.74 | $113.32 |
| MO | RR | $76.74 | $113.32 |
| MS | RR | $77.86 | $113.32 |
| MT | RR | $76.76 | $125.94 |
| NC | RR | $77.86 | $113.32 |
| ND | RR | $76.74 | $125.94 |
| NE | RR | $76.74 | $113.32 |
| NH | RR | $72.80 | $125.94 |
| NJ | RR | $74.43 | $113.32 |
| NM | RR | $77.50 | $118.65 |
| NV | RR | $74.66 | $125.94 |
| NY | RR | $74.43 | $125.94 |
| OH | RR | $75.89 | $125.94 |
| OK | RR | $77.50 | $125.94 |
| OR | RR | $74.66 | $125.94 |
| PA | RR | $74.43 | $120.84 |
| PR | RR | $161.23 | — |
| RI | RR | $72.80 | $113.32 |
| SC | RR | $77.86 | $113.32 |
| SD | RR | $76.74 | $125.94 |
| TN | RR | $77.86 | $113.32 |
| TX | RR | $77.50 | $125.94 |
| UT | RR | $76.76 | $125.94 |
| VA | RR | $77.86 | $113.46 |
| VI | RR | $125.94 | — |
| VT | RR | $72.80 | $125.94 |
| WA | RR | $74.66 | $125.94 |
| WI | RR | $75.89 | $115.97 |
| WV | RR | $77.86 | $116.88 |
| WY | RR | $76.76 | $113.32 |
How the E0261 fee compares
| Measure | Value |
|---|---|
| Rank among 34 E02 codes billed RR (lowest = 1) | 28 |
| Family fee range (average of state fees) | $1.55–$263.61 |
| Rural fee uplift | 50.0% |
Who bills E0261 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | 1,591 |
| Suppliers billing purchases | — |
| Referring clinicians | 14,510 |
| Medicare beneficiaries | 25,848 |
| States with claims | 52 |
| Share of services in top 3 states (New York, California, Florida) | 31% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,665 | 26,672 |
| 2023 | 1,603 | 25,825 |
| 2024 | 1,591 | 25,848 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0261, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 125,547 | 26,672 | $62.14 | $45.65 |
| 2023 | 123,332 | 25,825 | $66.89 | $49.16 |
| 2024 | 122,881 | 25,848 | $65.64 | $48.34 |
States with the most E0261 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 16,931 | $44.99 |
| California | 13,516 | $44.22 |
| Florida | 7,982 | $46.28 |
| Mississippi | 7,559 | $61.46 |
| Texas | 6,828 | $49.35 |
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 E0261
- 2026-01-01: Average state fee (RR) rose 2.6%: $78.33 to $80.40
- 1991-01-01: E0261 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 E0261?
E0261 is the HCPCS Level II code for hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress. Short descriptor: "Hosp bed semi-electr w/o mat".
How much does Medicare pay for E0261?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $72.80–$161.23. Rural fees can be higher.
Does Medicare cover E0261?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E0261 change in 2026?
The average non-rural state fee for RR moved from $78.33 in 2025 to $80.40 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0261 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 E0261
- Watch E0261 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0261
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.