Summary & Overview
HCPCS Level II E0294: Semi-Electric Hospital Bed with Mattress
HCPCS Level II code E0294 represents a semi-electric hospital bed with head and foot adjustment, supplied with a mattress and without side rails. This HCPCS code identifies a common durable medical equipment (DME) item used to support patients who need adjustable positioning for comfort, pressure relief, mobility assistance, or clinical care coordination. Nationally, accurate coding for such beds affects DME billing, care planning in post-acute settings, and coverage decisions across both commercial and public payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of semi-electric hospital beds, typical sites of service, and the role of this HCPCS Level II code in claims processing. The publication outlines common billing considerations, typical payer coverage patterns, and related coding references where available.
This summary equips billing managers, case managers, and policy analysts with the essential information needed to identify when E0294 applies, understand payer relevance, and locate additional benchmarking and policy content within the full publication. Data not available in the input will be noted in specific sections where relevant.
Billing Code Overview
HCPCS Level II code E0294 describes a hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress. This item is a durable medical equipment product intended to provide adjustable head and foot positioning for patients who require enhanced positioning support.
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Service type: Durable Medical Equipment (DME)
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Typical site of service: Hospital inpatient setting, long-term care facility, skilled nursing facility, or home when prescribed for use outside the acute care setting.
Clinical & Coding Specifications
Clinical Context
A homebound adult with limited mobility due to advanced congestive heart failure and chronic obstructive pulmonary disease requires a semi-electric hospital bed to support frequent head and foot elevation for respiratory comfort and pressure redistribution. Durable medical equipment (DME) ordering occurs after a clinician documents medical necessity, including functional limitations and respiratory or pressure-redistribution needs, and writes a DME prescription specifying a hospital bed with semi-electric head and foot adjustment and mattress. The DME supplier arranges delivery to the patient's residence or skilled nursing facility, performs a safety check and patient/caregiver education on controls and positioning, and documents delivery with signatures and photos as required by payors. Typical clinical workflow includes physician or advanced practice provider evaluation, documentation of mobility and positioning needs, DME order submission with relevant ICD-10 diagnosis codes, prior authorization when required, supplier delivery and setup, and follow-up to confirm fit and function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |
52 |