Summary & Overview
HCPCS E0296: Total Electric Hospital Bed with Mattress
HCPCS Level II code E0296 denotes a total electric hospital bed with head, foot, and height adjustments supplied with a mattress, and without side rails. This equipment supports mobility management, pressure redistribution, and caregiver ergonomics for patients who require powered repositioning and height changes. Nationally, E0296 is relevant across inpatient and home health care settings where durable medical equipment (DME) supports medically necessary bed needs and safe patient handling.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations, common billing modifiers and coding context (where provided), and the clinical role of a total electric hospital bed in care plans. The publication outlines expected sites of service and service line placement for billing, and identifies where input data is not available.
The report provides practical benchmarks and policy context to inform procurement, billing, and utilization decisions. It also highlights areas where payer policy alignment and documentation standards commonly affect claim adjudication. Data not available in the input is noted explicitly where applicable.
Billing Code Overview
HCPCS Level II code E0296 describes a hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress. This item is a durable medical equipment supply intended to provide full electric positioning of the head, foot, and overall bed height, and is supplied with a mattress.
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Service type: Durable Medical Equipment (DME) hospital bed
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Typical site of service: Inpatient hospital, long-term care facility, or home health settings where a powered hospital bed is required for patient care needs
Clinical & Coding Specifications
Clinical Context
A 78-year-old patient with advanced osteoarthritis and progressive functional decline is discharged from an inpatient stay after hip fracture repair. The patient lives alone with limited caregiver support and requires frequent positional changes for pressure injury prevention and respiratory hygiene. The durable medical equipment supplier delivers a E0296 hospital bed (total electric: head, foot, and height adjustments) with mattress to the patient’s home. The clinical workflow includes a physician order documenting medical necessity (e.g., immobility, risk of pressure ulcer, frequent repositioning needs), verification of coverage by the patient’s payor, delivery and setup by the supplier, patient/caregiver education on bed controls and safety, and documentation of delivery, fitting, and instruction in the medical record. Follow-up includes reassessment of ongoing need at home health visits or subsequent office encounters and coordination for return or upgrade if clinical status changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard - no modifier | Use when no performance or billing modifier is applicable |
52 |