E0197 — Air pressure pad for mattress, standard mattress length and width
E0197 is a HCPCS Level II code for air pressure pad for mattress, standard mattress length and width. It belongs to the Durable Medical Equipment section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of E0197 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for E0197
- Long descriptor
- Air pressure pad for mattress, standard mattress length and width
- Short descriptor
- Air pressure pad for mattres
- Added
- January 1, 1991
- BETOS
- D1E
- Pricing indicator
- 36 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Capped rental DME. Price subject to floors and ceilings.
Codes adjacent to E0197
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E0197 is not quite right, the correct code is very often within a few positions of it.
- E0187Water pressure mattress
- E0188Synthetic sheepskin pad
- E0189Lambswool sheepskin pad, any size
- E0190Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories
- E0191Heel or elbow protector, each
- E0193Powered air flotation bed (low air loss therapy)
- E0194Air fluidized bed
- E0196Gel pressure mattress
- E0198Water pressure pad for mattress, standard mattress length and width
- E0199Dry pressure pad for mattress, standard mattress length and width
- E0200Heat lamp, without stand (table model), includes bulb, or infrared element
- E0201Penile contracture device, manual, greater than 3 lbs traction force
- E0202Phototherapy (bilirubin) light with photometer
- E0203Therapeutic lightbox, minimum 10,000 lux, table top model
- E0205Heat lamp, with stand, includes bulb, or infrared element
- E0210Electric heat pad, standard
Questions about E0197
What is HCPCS code E0197?
E0197 is a HCPCS Level II code for air pressure pad for mattress, standard mattress length and width. It sits in the Durable Medical Equipment section.
Does Medicare cover E0197?
The CMS HCPCS file marks E0197 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.