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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.

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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.

Service type: Durable Medical Equipment (DME)
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.

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HCPCS Level II E0294: Semi-Electric Hospital Bed with Mattress

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Billing Code Overview

Service type: Durable Medical Equipment (DME)
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`	Reduced services	When a less than full hospital bed function is provided or a temporary downgrade is documented
`53`	Discontinued procedure	If delivery is attempted but canceled before setup due to patient or payer issues
`54`	Surgical care only	Rare for DME; used if a supplier only provides delivery separate from other services
`55`	Postoperative management only	Not commonly used; applies if billing is separated by care phase
`62`	Two surgeons	Uncommon for DME; used when two providers share responsibility in an associated procedure
`78`	Unplanned return to operating/procedure room	Not typical for DME; reserved for associated procedures requiring immediate return
`80`	Assistant surgeon	Not typical for DME; used when an assistant is billed for an associated procedure
`82`	Assistant surgeon (when qualified resident not available)	As above, uncommon for DME contexts
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When an advanced practice clinician provides the evaluation that supports the DME order
`RB`	Replacement of DME under warranty	When the bed or mattress is replaced under supplier warranty and billed accordingly
`QK`	Medical direction of two to four concurrent anesthesia procedures	Not typical for DME; included when anesthesia codes are part of the same encounter
`QX`	CRNA service with medical direction by a physician	Not typical for DME but retained for completeness in associated procedural care
`QY`	Medical direction of one CRNA by an anesthesiologist	Same as `QX` contextual use

Taxonomy Code	Specialty	Notes
`251B00000X`	Skilled Nursing Facility	Suppliers coordinate delivery to skilled nursing settings and nursing staff manage day-to-day use
`3336C0002X`	Durable Medical Equipment & Medical Supplies	Primary supplier specialty for ordering, fitting, delivering, and servicing hospital beds
`363L00000X`	Home Health Agency	Agencies commonly evaluate home safety and coordinate DME needs and setup
`208D00000X`	Critical Care Medicine	Physicians managing patients with respiratory compromise often document need for adjustable hospital bed
`207P00000X`	Internal Medicine	Primary care and hospitalists frequently document chronic disease limitations that justify bed rental or purchase

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.33`	Acute on chronic systolic (congestive) heart failure	Patients with orthopnea or dyspnea benefit from head elevation provided by an adjustable bed
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Head-of-bed elevation improves respiratory mechanics and secretion clearance
`M48.06`	Spinal stenosis, lumbar region	Patients with spine pathology often require adjustable positioning for comfort and pressure management
`G82.20`	Paraplegia, unspecified	Patients with lower extremity paralysis frequently need hospital beds for transfers and pressure redistribution
`Z99.89`	Dependence on other enabling machines and devices, not elsewhere classified	Indicates ongoing dependence on specialized equipment and supports bed necessity
`L89.309`	Pressure ulcer, unspecified stage, sacral region	Adjustable beds aid pressure redistribution and wound management
`R26.2`	Difficulty in walking, not elsewhere classified	Mobility impairment that supports medical necessity for a hospital bed

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Used when a clinician documents medical necessity and provides the order for the semi-electric hospital bed
`99507`	Home visit for the evaluation and management of a patient, home health; established patient, each additional 30 minutes	Used when home assessment is performed to verify safety and need for the bed (note: select appropriate home visit code based on payer guidance)
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	Occupational therapy evaluation or training for bed transfers and positioning that support DME use
`97112`	Neuromuscular reeducation, each 15 minutes	Physical therapy interventions to improve bed mobility and transfers associated with the bed prescription
`99502`	Home visit for post-surgical or post-procedural care	When supplier or clinician documents post-discharge needs and sets up the hospital bed in the home

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 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
`00`	No modifier	Standard reporting when no modifier applies
`52`	Reduced services	When a less than full hospital bed function is provided or a temporary downgrade is documented
`53`	Discontinued procedure	If delivery is attempted but canceled before setup due to patient or payer issues
`54`	Surgical care only	Rare for DME; used if a supplier only provides delivery separate from other services
`55`	Postoperative management only	Not commonly used; applies if billing is separated by care phase
`62`	Two surgeons	Uncommon for DME; used when two providers share responsibility in an associated procedure
`78`	Unplanned return to operating/procedure room	Not typical for DME; reserved for associated procedures requiring immediate return
`80`	Assistant surgeon	Not typical for DME; used when an assistant is billed for an associated procedure
`82`	Assistant surgeon (when qualified resident not available)	As above, uncommon for DME contexts
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	When an advanced practice clinician provides the evaluation that supports the DME order
`RB`	Replacement of DME under warranty	When the bed or mattress is replaced under supplier warranty and billed accordingly
`QK`	Medical direction of two to four concurrent anesthesia procedures	Not typical for DME; included when anesthesia codes are part of the same encounter
`QX`	CRNA service with medical direction by a physician	Not typical for DME but retained for completeness in associated procedural care
`QY`	Medical direction of one CRNA by an anesthesiologist	Same as `QX` contextual use

Taxonomy Code	Specialty	Notes
`251B00000X`	Skilled Nursing Facility	Suppliers coordinate delivery to skilled nursing settings and nursing staff manage day-to-day use
`3336C0002X`	Durable Medical Equipment & Medical Supplies	Primary supplier specialty for ordering, fitting, delivering, and servicing hospital beds
`363L00000X`	Home Health Agency	Agencies commonly evaluate home safety and coordinate DME needs and setup
`208D00000X`	Critical Care Medicine	Physicians managing patients with respiratory compromise often document need for adjustable hospital bed
`207P00000X`	Internal Medicine	Primary care and hospitalists frequently document chronic disease limitations that justify bed rental or purchase

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.33`	Acute on chronic systolic (congestive) heart failure	Patients with orthopnea or dyspnea benefit from head elevation provided by an adjustable bed
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Head-of-bed elevation improves respiratory mechanics and secretion clearance
`M48.06`	Spinal stenosis, lumbar region	Patients with spine pathology often require adjustable positioning for comfort and pressure management
`G82.20`	Paraplegia, unspecified	Patients with lower extremity paralysis frequently need hospital beds for transfers and pressure redistribution
`Z99.89`	Dependence on other enabling machines and devices, not elsewhere classified	Indicates ongoing dependence on specialized equipment and supports bed necessity
`L89.309`	Pressure ulcer, unspecified stage, sacral region	Adjustable beds aid pressure redistribution and wound management
`R26.2`	Difficulty in walking, not elsewhere classified	Mobility impairment that supports medical necessity for a hospital bed

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Used when a clinician documents medical necessity and provides the order for the semi-electric hospital bed
`99507`	Home visit for the evaluation and management of a patient, home health; established patient, each additional 30 minutes	Used when home assessment is performed to verify safety and need for the bed (note: select appropriate home visit code based on payer guidance)
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	Occupational therapy evaluation or training for bed transfers and positioning that support DME use
`97112`	Neuromuscular reeducation, each 15 minutes	Physical therapy interventions to improve bed mobility and transfers associated with the bed prescription
`99502`	Home visit for post-surgical or post-procedural care	When supplier or clinician documents post-discharge needs and sets up the hospital bed in the home

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 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 Level II E0294: Semi-Electric Hospital Bed with Mattress

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Billing Code Overview

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HCPCS Level II E0294: 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

HCPCS Level II E0294: Semi-Electric Hospital Bed with Mattress

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Billing Code Overview

HCPCS Level II E0294: Semi-Electric Hospital Bed with Mattress

Sign up for hcpcs E0294 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code E0294 represent and where is it typically used?

What documentation and clinical workflow support ordering E0294?

Which diagnosis codes are commonly associated with medical necessity for this semi-electric bed?

Which modifiers might be applied when billing E0294 and what do they indicate?

Which payers are included in the coverage analysis and where can I find payer-specific rules?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code E0294 represent and where is it typically used?

What documentation and clinical workflow support ordering E0294?

Which diagnosis codes are commonly associated with medical necessity for this semi-electric bed?

Which modifiers might be applied when billing E0294 and what do they indicate?

Which payers are included in the coverage analysis and where can I find payer-specific rules?

References