E0261 — Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress
E0261 is a HCPCS Level II code for hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress. 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 E0261 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 E0261
- Long descriptor
- Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress
- Short descriptor
- Hosp bed semi-electr w/o mat
- Added
- January 1, 1991
- BETOS
- D1B
- 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 E0261
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E0261 is not quite right, the correct code is very often within a few positions of it.
- E0247Transfer bench for tub or toilet with or without commode opening
- E0248Transfer bench, heavy duty, for tub or toilet with or without commode opening
- E0249Pad for water circulating heat unit, for replacement only
- E0250Hospital bed, fixed height, with any type side rails, with mattress
- E0251Hospital bed, fixed height, with any type side rails, without mattress
- E0255Hospital bed, variable height, hi-lo, with any type side rails, with mattress
- E0256Hospital bed, variable height, hi-lo, with any type side rails, without mattress
- E0260Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
- E0265Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress
- E0266Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress
- E0270Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress
- E0271Mattress, innerspring
- E0272Mattress, foam rubber
- E0273Bed board
- E0274Over-bed table
- E0275Bed pan, standard, metal or plastic
Questions about E0261
What is HCPCS code E0261?
E0261 is a HCPCS Level II code for hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress. It sits in the Durable Medical Equipment section.
Does Medicare cover E0261?
The CMS HCPCS file marks E0261 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.