This page describes the qualifications in the Certificate of Medical Necessity for each of the following bed types, as required by CMS.
Please also refer to general requirements for prescribing durable medical equipment (DME).
For patients who prefer to purchase a bed with their own funds on option is www.transfermaster.com/home-hospital-beds
Fixed Height Bed
Does the patient require ANY of the following?
Find the Certificate of Medical Necessity on Epic.
Variable Height Bed
(E0255, E0256, E0292, E0293)
Covered if:
- The patient meets one of the criteria for a fixed height hospital bed
- AND the patient requires a bed height different than a fixed height hospital bed to permit transfers to chair, wheelchair, or standing position
Chart notes should justify that the patient needs to be elevated above 30 degrees for better breathing or PEG feeding, or, need to be positioned in a way that a regular bed is unable of performing for the patient with limited or no mobility at all and has difficulty transferring from bed surface to wheelchair, commode, or hoyer lift.
Semi-electric Hospital Bed
(E0260, E0261, E0294, E0295, E0329)
Covered if:
- The patient meets one of the criteria for a fixed height hospital bed
- AND the patient requires frequent changes in body position and/or has an immediate need for a change in body position
Chart notes should justify that the patient needs to be elevated above 30 degrees for better breathing or PEG feeding, or, need to be positioned in a way that a regular bed is unable of performing for the patient with limited or no mobility at all and has difficulty transferring from bed surface to wheelchair, commode, or hoyer lift.
Heavy-Duty Extra Wide Hospital Bed
(E0301, E0303)
Covered if:
- The patient meets one of the criteria for a fixed height hospital bed
- AND the patient's weight is more than 350 pounds but does not exceed 600 pounds
Chart notes should justify that the patient needs to be elevated above 30 degrees for better breathing or PEG feeding, or, need to be positioned in a way that a regular bed is unable of performing for the patient with limited or no mobility at all and has difficulty transferring from bed surface to wheelchair, commode, or hoyer lift.
Extra Heavy-Duty Hospital Bed
(E0302, E0304)
Covered if:
- The patient meets one of the criteria for a fixed height hospital bed
- AND the patient's weight exceeds 600 pounds
Chart notes should justify that the patient needs to be elevated above 30 degrees for better breathing or PEG feeding, or, need to be positioned in a way that a regular bed is unable of performing for the patient with limited or no mobility at all and has difficulty transferring from bed surface to wheelchair, commode, or hoyer lift.
Total Electric Hospital Bed
(E0265, E0266, E0296, E0297)
NOT Covered:
- Height adjustment feature is a convenience feature
- Total electric beds will be denied as not reasonable/necessary