HCPCS code E0185: Gel or gel-like pressure pad for mattress

Obtain a list of the documentation and billing requirements needed to properly code and bill for HCPCS code E0185 from our short guide.

Use Code

Frequently asked questions

E0185 is a pad or overlay that is placed on top of a standard mattress. E0196 is a full replacement mattress with gel material. E0185 is typically a simpler and less costly device.

A Group 1 support surface, such as E0185, is generally covered for patients with Stage I or Stage II pressure ulcers. For patients with Stage III or Stage IV ulcers, a more advanced support surface (typically Group 2 or 3) is usually required and must be medically justified with documentation showing a failure of conservative treatment, which may have included a Group 1 device.

The Centers for Medicare & Medicaid Services (CMS) assigns a five-year reasonable useful lifetime (RUL) to many DME items. Replacement before this five-year mark is generally only covered if the item is lost, stolen, or damaged beyond repair due to an irreversible event.