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HCPCS E0260: Semi-Electric Hospital Bed with Mattress

HCPCS Level II code E0260 represents a semi-electric hospital bed with head and foot adjustment, side rails, and mattress. As a common durable medical equipment (DME) item, this bed supports patients who need adjustable positioning for comfort, mobility assistance, pressure injury prevention, or clinical care in institutional and home settings. Nationally, coverage and utilization of E0260 influence long-term care, home health, and durable medical equipment supply chains.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coverage considerations, coding context, and the clinical role of semi-electric hospital beds. The report outlines typical sites of service and service type, summarizes payer handling where available, and identifies where data is not provided.

This publication is designed to help billing managers, DME suppliers, and policy analysts understand how HCPCS Level II code E0260 is characterized, what clinical needs it addresses, and what elements to consider when documenting and submitting claims. Data not available in the input is noted where applicable.

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Billing Code Overview

HCPCS Level II code E0260 describes a hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress. This DME (durable medical equipment) item is intended to provide adjustable support for patients who require positional changes for comfort, pressure redistribution, or clinical care needs.

Service type: Durable medical equipment — semi-electric hospital bed with mattress and side rails
Typical site of service: Inpatient or home medical settings where a hospital-style bed is required, including skilled nursing facilities, long-term care, and home health environments

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HCPCS E0260: Semi-Electric Hospital Bed with Mattress

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Billing Code Overview

Service type: Durable medical equipment — semi-electric hospital bed with mattress and side rails
Typical site of service: Inpatient or home medical settings where a hospital-style bed is required, including skilled nursing facilities, long-term care, and home health environments

Clinical & Coding Specifications

Clinical Context

A patient with limited mobility is discharged from an acute care hospital to home with home health services following hip fracture surgery. The patient requires a safe, adjustable bed to reduce fall risk, facilitate pressure redistribution, and allow caregiver assistance for transfers and positioning. A physical therapist documents ongoing need for head and foot elevation to assist pulmonary clearance and reduce orthostatic stress; occupational therapy documents need for side rails to assist repositioning and caregiver transfers. The durable medical equipment supplier arranges delivery of a semi-electric hospital bed, coded as E0260, at the patient’s residence. The clinical workflow includes physician or advanced practice clinician assessment and order for the bed, documentation of medical necessity in the plan of care (including functional limitations, weight-bearing status, and home environment), prior authorization/benefit verification with the patient’s insurer, delivery and setup by the supplier, patient/caregiver education on bed controls and rail use, and follow-up visits by home health clinicians to document continued need or modification of equipment.

Coding Specifications

Modifier	Description	When to Use
`KA`	Data not available in the input.	Data not available in the input.
`00`	Default or no modifier.	Use when no additional modifier is required.
`52`	Reduced services.	Use if a reduced service or partial provision of the bed occurs.
`53`	Discontinued procedure.	Use if delivery is attempted but the service is canceled prior to completion.
`55`	Postoperative management only.	Use when billing reflects only post-op management components tied to durable equipment setup.
`62`	Two surgeons.	Rarely applicable; use only if two suppliers/providers share responsibility requiring split billing.
`78`	Unplanned return to operating/procedure room by same physician following initial procedure.	Uncommon for DME; use only if related to an unplanned return procedure impacting equipment provision.
`80`	Assistant surgeon.	Rare for DME; applies if an assistant provider is separately billing related services.
`82`	Assistant surgeon (when qualified resident not available).	See `80`; rarely applicable for durable equipment.
`KX`	Requirements specified in the medical policy are met.	Use to indicate that payer-specific documentation or policy criteria have been met for coverage.
`RR`	Repeat procedure by another physician.	Use if another provider repeats a related procedure impacting equipment need.
`QK`	Medical direction of two, three, or four assistants.	Typically not applicable; include only when payment rules require it for related professional services.
`QX`	Modifier for documentation of assistant at surgery; applies per payer rules.	Rarely applicable to DME; include if payer requires modifier for associated professional services.
`TW`	Services provided in whole or part by a resident under Medicare rules.	Use when teaching physician/resident involvement affects billing in related services.

Taxonomy Code	Specialty	Notes
`143700000X`	Physical Therapist	Commonly evaluates mobility and documents need for adjustable bed for functional status and safe transfers.
`221H00000X`	Home Health Agency	Coordinates durable medical equipment delivery and documents homebound status and need for bed.
`207Q00000X`	Orthopedic Surgeon	Orders equipment post-surgery for healing, weight-bearing restrictions, and safe positioning.
`208D00000X`	Internist / Primary Care	Manages chronic conditions (e.g., COPD, CHF) that may necessitate semi-electric bed for symptom management.
`364S00000X`	Durable Medical Equipment Supplier	Supplies, delivers, and sets up `E0260` equipment; documents delivery and patient education.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M84.451A`	Pathological fracture, right femur, initial encounter for fracture.	Postoperative mobility limitations and need for adjustable bed to facilitate transfer and positioning after hip fracture repair.
`M84.452A`	Pathological fracture, left femur, initial encounter for fracture.	Same relevance for left-sided fractures requiring bed for safe recovery and pressure management.
`R53.2`	Functional quadriplegia.	Severe mobility impairment indicating need for a semi-electric bed with rails for positioning and caregiver assistance.
`I50.9`	Heart failure, unspecified.	Patients with heart failure may require head elevation to reduce orthopnea; semi-electric bed supports symptom management.
`J44.9`	Chronic obstructive pulmonary disease, unspecified.	COPD patients may need head-of-bed elevation to assist breathing and pulmonary therapies; bed supports respiratory care.
`L89.90`	Pressure ulcer of unspecified site, unspecified stage.	Presence of pressure injuries or high risk justifies adjustable bed and specialized mattress for pressure redistribution.
`Z74.09`	Other reduced mobility.	General code documenting limited mobility and need for durable medical equipment such as `E0260`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes.	Performed by therapists to train patient/caregiver on bed transfers and functional use of the semi-electric bed during discharge planning.
`99341`	Home visit for the evaluation and management of a new patient, typically 20 minutes.	Home health or primary care evaluation that may include ordering `E0260` and documenting medical necessity in the home setting.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes.	Included when counseling impacts respiratory status and bed needs; occasionally performed during home visits addressing pulmonary risk factors.
`94640`	Pressurized or non-pressurized inhalation treatment for acute airway obstruction.	Performed in home health situations where bed positioning (head elevation) assists respiratory treatments; relates to clinical justification for adjustable bed.
`97597`	Debridement; selective debridement, open wound, including topical application(s), wound(s) care.	Performed when pressure redistribution and mattress included with `E0260` are part of pressure injury prevention and wound care planning.

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

HCPCS E0105: Cane, Quad or Three Prong, Adjustable or Fixed

HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

HCPCS E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

HCPCS E0111: Crutch Forearm, Includes Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS E0112: Underarm Wooden Crutches, Pair, with Pads and Handgrips

HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

HCPCS Level II E0113: Crutch Underarm, Wood, with Pad, Tip and Handgrip

HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

HCPCS E0114: Underarm Crutches, Non-Wood, Pair, Adjustable or Fixed

HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

HCPCS E0116: Underarm Crutch, Non‑Wood, Adjustable or Fixed

HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

HCPCS E0117: Articulating, Spring-Assisted Underarm Crutch

HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

HCPCS E0118: Lower Leg Platform Crutch Substitute

Showing 1–10 of 670

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`KA`	Data not available in the input.	Data not available in the input.
`00`	Default or no modifier.	Use when no additional modifier is required.
`52`	Reduced services.	Use if a reduced service or partial provision of the bed occurs.
`53`	Discontinued procedure.	Use if delivery is attempted but the service is canceled prior to completion.
`55`	Postoperative management only.	Use when billing reflects only post-op management components tied to durable equipment setup.
`62`	Two surgeons.	Rarely applicable; use only if two suppliers/providers share responsibility requiring split billing.
`78`	Unplanned return to operating/procedure room by same physician following initial procedure.	Uncommon for DME; use only if related to an unplanned return procedure impacting equipment provision.
`80`	Assistant surgeon.	Rare for DME; applies if an assistant provider is separately billing related services.
`82`	Assistant surgeon (when qualified resident not available).	See `80`; rarely applicable for durable equipment.
`KX`	Requirements specified in the medical policy are met.	Use to indicate that payer-specific documentation or policy criteria have been met for coverage.
`RR`	Repeat procedure by another physician.	Use if another provider repeats a related procedure impacting equipment need.
`QK`	Medical direction of two, three, or four assistants.	Typically not applicable; include only when payment rules require it for related professional services.
`QX`	Modifier for documentation of assistant at surgery; applies per payer rules.	Rarely applicable to DME; include if payer requires modifier for associated professional services.
`TW`	Services provided in whole or part by a resident under Medicare rules.	Use when teaching physician/resident involvement affects billing in related services.

Taxonomy Code	Specialty	Notes
`143700000X`	Physical Therapist	Commonly evaluates mobility and documents need for adjustable bed for functional status and safe transfers.
`221H00000X`	Home Health Agency	Coordinates durable medical equipment delivery and documents homebound status and need for bed.
`207Q00000X`	Orthopedic Surgeon	Orders equipment post-surgery for healing, weight-bearing restrictions, and safe positioning.
`208D00000X`	Internist / Primary Care	Manages chronic conditions (e.g., COPD, CHF) that may necessitate semi-electric bed for symptom management.
`364S00000X`	Durable Medical Equipment Supplier	Supplies, delivers, and sets up `E0260` equipment; documents delivery and patient education.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M84.451A`	Pathological fracture, right femur, initial encounter for fracture.	Postoperative mobility limitations and need for adjustable bed to facilitate transfer and positioning after hip fracture repair.
`M84.452A`	Pathological fracture, left femur, initial encounter for fracture.	Same relevance for left-sided fractures requiring bed for safe recovery and pressure management.
`R53.2`	Functional quadriplegia.	Severe mobility impairment indicating need for a semi-electric bed with rails for positioning and caregiver assistance.
`I50.9`	Heart failure, unspecified.	Patients with heart failure may require head elevation to reduce orthopnea; semi-electric bed supports symptom management.
`J44.9`	Chronic obstructive pulmonary disease, unspecified.	COPD patients may need head-of-bed elevation to assist breathing and pulmonary therapies; bed supports respiratory care.
`L89.90`	Pressure ulcer of unspecified site, unspecified stage.	Presence of pressure injuries or high risk justifies adjustable bed and specialized mattress for pressure redistribution.
`Z74.09`	Other reduced mobility.	General code documenting limited mobility and need for durable medical equipment such as `E0260`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes.	Performed by therapists to train patient/caregiver on bed transfers and functional use of the semi-electric bed during discharge planning.
`99341`	Home visit for the evaluation and management of a new patient, typically 20 minutes.	Home health or primary care evaluation that may include ordering `E0260` and documenting medical necessity in the home setting.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes.	Included when counseling impacts respiratory status and bed needs; occasionally performed during home visits addressing pulmonary risk factors.
`94640`	Pressurized or non-pressurized inhalation treatment for acute airway obstruction.	Performed in home health situations where bed positioning (head elevation) assists respiratory treatments; relates to clinical justification for adjustable bed.
`97597`	Debridement; selective debridement, open wound, including topical application(s), wound(s) care.	Performed when pressure redistribution and mattress included with `E0260` are part of pressure injury prevention and wound care planning.

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

HCPCS E0105: Cane, Quad or Three Prong, Adjustable or Fixed

HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

HCPCS E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

HCPCS E0111: Crutch Forearm, Includes Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS E0112: Underarm Wooden Crutches, Pair, with Pads and Handgrips

HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

HCPCS Level II E0113: Crutch Underarm, Wood, with Pad, Tip and Handgrip

HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

HCPCS E0114: Underarm Crutches, Non-Wood, Pair, Adjustable or Fixed

HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

HCPCS E0116: Underarm Crutch, Non‑Wood, Adjustable or Fixed

HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

HCPCS E0117: Articulating, Spring-Assisted Underarm Crutch

HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

HCPCS E0118: Lower Leg Platform Crutch Substitute

Showing 1–10 of 670

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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HCPCS E0260: Semi-Electric Hospital Bed with Mattress

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Billing Code Overview

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HCPCS E0260: Semi-Electric Hospital Bed with Mattress

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References