Key facts for E0625
- Medicare payment
- not separately priced
- HCPCS pricing indicator 00 (Part B)
- Coverage code
- M
- non-covered by Medicare
- Practitioner MUE
- 0
- MAI 3
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 1 / 0
TL;DR
CMS describes HCPCS E0625, added in 1986, as "Patient lift, bathroom or toilet, not otherwise classified". Part B does not price E0625 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0625. MUE limits for E0625: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). 1 active LCD lists E0625: L33799 (Patient Lifts). OPPS status indicator E1: Non-allowed item or service. HCPCS record: BETOS D1E (other DME); pricing indicator 00; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). 4 other active codes open with "Patient lift"; related codes: E0630, E0635, E0639, E0640.
E0625 descriptor and code status
The October 2026 HCPCS Level II file describes E0625 as “Patient lift, bathroom or toilet, not otherwise classified”. It sits in the E section (durable medical equipment), listed with the other E codes.
| Field | Value |
|---|---|
| Short descriptor | Patient lift bathroom or toi |
| Added to HCPCS | 1986-01-01 |
| Last action | N (no maintenance), effective 2005-01-01 |
| Coverage code | M: non-covered by Medicare |
| Pricing indicator | 00: not separately priced by Part B |
| BETOS category | D1E: other DME |
| Type of service | A: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME |
Medicare payment for E0625
Part B does not price E0625 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0625. 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.
Hospital outpatient (OPPS Addendum B)
Status indicator E1 (Non-allowed item or service), with no separate OPPS payment rate.
Medically Unlikely Edits for E0625
MUE limits for E0625: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
| Facility outpatient hospital | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
| DME supplier | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
The MUE lookup for E0625 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists E0625 in v323r0.
E0625 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 E0625 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for E0625
1 active Local Coverage Determination and 0 billing and coding articles list E0625. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- LCD L33799: Patient Lifts · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
Denials to expect on E0625
the diagnosis or documentation does not meet the LCD or billing article that lists E0625
the modifier reported is inconsistent with the code
the claim lacks the description, invoice or pricing detail a contractor-priced code needs
Where QuickIntell fits for E0625 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for E0625 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS E0625
What does HCPCS code E0625 describe?
"Patient lift, bathroom or toilet, not otherwise classified" (short descriptor "Patient lift bathroom or toi"), in the E section (durable medical equipment). Added 1986-01-01; last action N (no maintenance) effective 2005-01-01.
Is E0625 a CPT code?
No: CMS maintains E0625 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.
What does Medicare pay for E0625?
Part B does not price E0625 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0625.
How many units of E0625 can be billed per day?
MUE limits for E0625: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). For the practitioner MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover E0625?
Coverage code M (non-covered by Medicare). 1 active LCD lists E0625: L33799 (Patient Lifts).
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
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.