Hospital Beds
Note: The following coverage criteria is for Medicare, other insurances may have different criteria and may be less stringent. In most cases, meeting Medicare criteria will meet all other criteria’s.
- A written signed and dated prescription prior to dispensing is required before a hospital bed is covered by Medicare.
- The face to face notes must include the conditions for coverage as described below (these must be completed and signed prior to dispensing the item):
A fixed height hospital bed (E0250, EC25, EG290, and E0241) is covered if one or more of the following criteria are met:
- The patient has a medical condition which requires positioning of the body in ways not feasible with an ordinary bed. Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed, or
- The patient requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain, or
- The patient requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration. Pillows or wedges must have been considered and ruled out, or
- The patient requires traction equipment, which can only be attached to a hospital bed.
.
A semi-electric hospital bed (E0260, E0261, E0294, and E0295) is covered if the patient meets one of the criteria for a fixed height bed and requires frequent changes in body position and/or has an immediate need for a change in body position.
A heavy duty extra wide hospital bed (E0301, E0303) is 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.
An extra heavy duty hospital bed (E0302, E0304) is covered if the patient meets one of the criteria for a hospital bed and the patient's weight exceeds 600 pounds.