Find policies, billing codes, payers, states, and providers

HCPCS E0265: Total Electric Hospital Bed with Mattress

HCPCS Level II code E0265 designates a fully electric hospital bed with head, foot, and height adjustments, side rails, and an included mattress. This equipment supports medically necessary positioning, pressure management, and caregiver tasks across institutional care settings. Nationally, billing and coverage for electric hospital beds affect hospital, long-term care, and durable medical equipment supply chains and are relevant to post-acute care resource planning.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of what the code represents, typical sites of service, and the clinical contexts in which a fully electric hospital bed is used. The publication summarizes how payers commonly handle coverage for hospital beds, presents benchmark considerations for utilization and billing, and outlines relevant policy and coding guidance where available.

This analysis is written for a national audience and provides operational clarity for billing staff, DME suppliers, hospital discharge planners, and policy analysts seeking concise guidance about HCPCS Level II code E0265 and its role in delivering institution-based patient support.

Customize your policy alerts

Sign up for hcpcs E0265 policy alerts

Get alerted when payer policies referencing E0265 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

HCPCS Level II code E0265 describes a hospital bed, total electric with head, foot, and height adjustments, equipped with any type of side rails and including a mattress. This durable medical equipment item is intended to support patients who require adjustable positioning for medical care, mobility assistance, pressure relief, or caregiver access.

Service type: Durable Medical Equipment (DME) hospital bed (electric, fully adjustable)
Typical site of service: Inpatient settings such as hospitals, long-term acute care facilities, long-term care and skilled nursing facilities, and other institutional care locations where a full electric hospital bed with mattress is required.

Find policies, billing codes, payers, states, and providers

HCPCS E0265: Total Electric Hospital Bed with Mattress

Customize your policy alerts

Sign up for hcpcs E0265 policy alerts

Get alerted when payer policies referencing E0265 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Durable Medical Equipment (DME) hospital bed (electric, fully adjustable)
Typical site of service: Inpatient settings such as hospitals, long-term acute care facilities, long-term care and skilled nursing facilities, and other institutional care locations where a full electric hospital bed with mattress is required.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with limited mobility, complex medical needs, or recent major surgery who requires a full-electric hospital bed for safe positioning, pressure redistribution, and caregiver handling at home or in a skilled nursing facility. The durable medical equipment order for E0265 is initiated by a treating physician or advanced practice clinician after an in-person evaluation documenting medical necessity (e.g., inability to safely reposition in a standard bed, need for frequent head/foot elevation to manage respiratory compromise or edema, or need for height adjustment to facilitate transfers).

The clinical workflow: the clinician documents mobility limitations, skin integrity risk, respiratory or cardiac indications, and home environment factors. A DME supplier verifies the prescription, conducts a home assessment, delivers and sets up the E0265 total electric hospital bed with mattress, trains patient and caregiver on operation and safety (including side rails), and records delivery and education in the patient record. Follow-up visits or durable medical equipment reassessments occur as clinically indicated to document ongoing medical necessity and maintenance needs.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	When a less than full hospital bed is furnished or components are omitted from the ordered configuration.
`53`	Discontinued procedure	Rarely used; if delivery is initiated but canceled prior to completion.
`62`	Two surgeons	Not typically applicable; included for completeness when multiple providers coordinate complex DME orders.
`78`	Return to operating room	Not applicable to DME furnishing; reserved for procedural contexts.
`80`	Assistant surgeon	Not applicable to DME furnishing; reserved for surgical services.
`82`	Assistant surgeon (when qualified resident not available)	Not applicable to DME furnishing.
`LT`	Left side (note: not in provided list)	Data not available in the input.
`RR`	Recovery room (note: often payer-specific)	When bed delivery is associated with transition from facility to home requiring transitional services (payer-specific use).
`TC`	Technical component	When billing separates technical delivery/setup from provider professional services (supplier technical charge).
`KJ`	Modifier indicating services rendered under certain state worker compensation rules	When furnishing DME for specific workers' compensation scenarios (state/payer-specific application).
`MS`	Medicare Secondary Payer? (note: `MS` in list is payer-specific)	When Medicare is secondary and specific reporting is required by the supplier.

Taxonomy Code	Specialty	Notes
`174400000X`	Physical Therapist	PTs commonly evaluate mobility and recommend bed features for transfers and pressure management.
`208000000X`	Family Medicine	Primary care clinicians often order home hospital beds for chronic illness management.
`207Q00000X`	Internal Medicine	Hospitalists and internists document medical necessity during hospitalization and transition-of-care orders.
`363LP0200X`	Rehabilitation Physician (Physiatrist)	Physiatrists evaluate functional needs and prescribe bed configuration for rehabilitation and pressure reduction.
`333600000X`	Occupational Therapist	OTs assess home transfer needs and bed compatibility with assistive devices.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M62.81`	Muscle weakness (generalized)	Weakness limiting ability to reposition, necessitating an adjustable hospital bed for safe positioning and transfers.
`R26.2`	Difficulty in walking, not elsewhere classified	Patients with gait instability may require height-adjustable beds to facilitate safe transfers and caregiver assistance.
`R09.02`	Hypoxemia	Respiratory compromise that benefits from head-of-bed elevation and frequent adjustments provided by `E0265`.
`I50.9`	Heart failure, unspecified	Patients with fluid overload may need head/foot elevation to manage edema and dyspnea.
`L89.9`	Pressure ulcer, unspecified site, stage unspecified	High risk or existing pressure injuries drive need for specific mattress and bed positioning capabilities included with `E0265`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`95851`	Home sleep testing for diagnosis of sleep apnea	May precede ordering a hospital bed when nocturnal hypoxemia or positional respiratory compromise influences bed selection.
`99501`	Home visit for direct patient care by a physician or other qualified healthcare professional	Used when an in-home evaluation supports the medical necessity for `E0265` furnishing.
`98960`	Education and training for patient self-management for a new DME device (per 30 minutes)	Reflects clinician or supplier-provided training on bed operation and safety (note: payers vary on exact CPT usage for education services).
`99406`	Smoking and tobacco use cessation counseling visit	Indirectly related when comorbidities (e.g., COPD) that affect bed needs are managed; counseling may occur during clinical encounters for DME justification.
`G0154`	Home health or hospice assessment by a qualified clinician	Used to document comprehensive home assessment that supports the need for a total electric hospital bed.

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

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	When a less than full hospital bed is furnished or components are omitted from the ordered configuration.
`53`	Discontinued procedure	Rarely used; if delivery is initiated but canceled prior to completion.
`62`	Two surgeons	Not typically applicable; included for completeness when multiple providers coordinate complex DME orders.
`78`	Return to operating room	Not applicable to DME furnishing; reserved for procedural contexts.
`80`	Assistant surgeon	Not applicable to DME furnishing; reserved for surgical services.
`82`	Assistant surgeon (when qualified resident not available)	Not applicable to DME furnishing.
`LT`	Left side (note: not in provided list)	Data not available in the input.
`RR`	Recovery room (note: often payer-specific)	When bed delivery is associated with transition from facility to home requiring transitional services (payer-specific use).
`TC`	Technical component	When billing separates technical delivery/setup from provider professional services (supplier technical charge).
`KJ`	Modifier indicating services rendered under certain state worker compensation rules	When furnishing DME for specific workers' compensation scenarios (state/payer-specific application).
`MS`	Medicare Secondary Payer? (note: `MS` in list is payer-specific)	When Medicare is secondary and specific reporting is required by the supplier.

Taxonomy Code	Specialty	Notes
`174400000X`	Physical Therapist	PTs commonly evaluate mobility and recommend bed features for transfers and pressure management.
`208000000X`	Family Medicine	Primary care clinicians often order home hospital beds for chronic illness management.
`207Q00000X`	Internal Medicine	Hospitalists and internists document medical necessity during hospitalization and transition-of-care orders.
`363LP0200X`	Rehabilitation Physician (Physiatrist)	Physiatrists evaluate functional needs and prescribe bed configuration for rehabilitation and pressure reduction.
`333600000X`	Occupational Therapist	OTs assess home transfer needs and bed compatibility with assistive devices.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M62.81`	Muscle weakness (generalized)	Weakness limiting ability to reposition, necessitating an adjustable hospital bed for safe positioning and transfers.
`R26.2`	Difficulty in walking, not elsewhere classified	Patients with gait instability may require height-adjustable beds to facilitate safe transfers and caregiver assistance.
`R09.02`	Hypoxemia	Respiratory compromise that benefits from head-of-bed elevation and frequent adjustments provided by `E0265`.
`I50.9`	Heart failure, unspecified	Patients with fluid overload may need head/foot elevation to manage edema and dyspnea.
`L89.9`	Pressure ulcer, unspecified site, stage unspecified	High risk or existing pressure injuries drive need for specific mattress and bed positioning capabilities included with `E0265`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`95851`	Home sleep testing for diagnosis of sleep apnea	May precede ordering a hospital bed when nocturnal hypoxemia or positional respiratory compromise influences bed selection.
`99501`	Home visit for direct patient care by a physician or other qualified healthcare professional	Used when an in-home evaluation supports the medical necessity for `E0265` furnishing.
`98960`	Education and training for patient self-management for a new DME device (per 30 minutes)	Reflects clinician or supplier-provided training on bed operation and safety (note: payers vary on exact CPT usage for education services).
`99406`	Smoking and tobacco use cessation counseling visit	Indirectly related when comorbidities (e.g., COPD) that affect bed needs are managed; counseling may occur during clinical encounters for DME justification.
`G0154`	Home health or hospice assessment by a qualified clinician	Used to document comprehensive home assessment that supports the need for a total electric hospital bed.

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

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

OpenPayer

HCPCS E0265: Total Electric Hospital Bed with Mattress

Sign up for hcpcs E0265 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

HCPCS E0265: Total Electric Hospital Bed with Mattress

Sign up for hcpcs E0265 policy alerts

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

HCPCS E0265: Total Electric Hospital Bed with Mattress

Sign up for hcpcs E0265 policy alerts

Billing Code Overview

HCPCS E0265: Total Electric Hospital Bed with Mattress

Sign up for hcpcs E0265 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code E0265 represent?

How is medical necessity for E0265 established and documented?

What are the supplier’s responsibilities when furnishing an E0265 bed?

Which modifiers are relevant when billing for E0265?

What CPT/assessment codes and diagnoses are commonly associated with E0265 claims?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code E0265 represent?

How is medical necessity for E0265 established and documented?

What are the supplier’s responsibilities when furnishing an E0265 bed?

Which modifiers are relevant when billing for E0265?

What CPT/assessment codes and diagnoses are commonly associated with E0265 claims?

References