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HCPCS E0260 · Level II · DME code

E0260: Hospital bed, semi-electric (head and foot adjustment), with any type side rails, HCPCS Level II DME code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for E0260

Medicare payment
$72.80 to $78.16
DMEPOS non-rural state fees (RR)
Coverage code
D
special coverage instructions apply
DME supplier MUE
1
MAI 2
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

HCPCS Level II E0260 reads "Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress" in the October 2026 file; it dates from 1986. The October 2026 DMEPOS fee schedule (category CR, capped rental items) sets E0260 at RR (rental) $72.80 in CT, MA, ME and 3 more to $78.16 in AL, AR, FL and 9 more, rural $128.13 to $128.15. CMS caps E0260 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. 1 active LCD lists E0260: L33820 (Hospital Beds And Accessories). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1B (hospital beds); pricing indicator 36; type of service R (rental of DME). 22 other active codes open with "Hospital bed"; related codes: E0261, E0255, E0265, E0250.

E0260 descriptor and code status

The October 2026 HCPCS Level II file describes E0260 as “Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0260
FieldValue
Short descriptorHosp bed semi-electr w/ matt
Added to HCPCS1986-01-01
Last actionN (no maintenance), effective 1991-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator36: DMEPOS capped rental DME (floors and ceilings)
BETOS categoryD1B: hospital beds
Type of serviceR: rental of DME

Medicare payment for E0260

The October 2026 DMEPOS fee schedule (category CR, capped rental items) sets E0260 at RR (rental) $72.80 in CT, MA, ME and 3 more to $78.16 in AL, AR, FL and 9 more, rural $128.13 to $128.15. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category CR (capped rental items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for E0260 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
RR (rental)—$72.80 (CT, MA, ME…) to $78.16 (AL, AR, FL…)$128.13 (CT, ME, VT) to $128.15 (IA, LA, RI)AK $128.13, HI $128.14, PR $128.14, VI $128.14

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for E0260

CMS caps E0260 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for E0260 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for E0260 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0260 in v323r0.

E0260 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check E0260 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0260

1 active Local Coverage Determination and 0 billing and coding articles list E0260. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on E0260

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E0260

CARC 151 · N362

units of E0260 exceed the DME supplier MUE of 1 per date of service

CARC 4

the RR payment modifier is missing or does not match the item

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for E0260 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for E0260 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E0260

What does HCPCS code E0260 describe?

"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress" (short descriptor "Hosp bed semi-electr w/ matt"), in the E section (durable medical equipment). Added 1986-01-01; last action N (no maintenance) effective 1991-01-01.

Is E0260 a CPT code?

It is not. E0260 belongs to the E section (durable medical equipment) of HCPCS Level II, the CMS code set, not to AMA CPT. "E0260 CPT code" searches refer to it.

What does Medicare pay for E0260?

The October 2026 DMEPOS fee schedule (category CR, capped rental items) sets E0260 at RR (rental) $72.80 in CT, MA, ME and 3 more to $78.16 in AL, AR, FL and 9 more, rural $128.13 to $128.15.

How many units of E0260 can be billed per day?

CMS caps E0260 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover E0260?

Coverage code D (special coverage instructions apply). 1 active LCD lists E0260: L33820 (Hospital Beds And Accessories).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.