HCPCS code E0261: Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress

E0261 excludes a mattress (bed frame only), whereas E0260 includes a mattress. Clinical necessity and billing differ accordingly—separate billing for mattress may apply.

No. Side rails are included in the descriptor for E0261; separate billing for side rails (e.g., via E0305/E0310) within 180 days is generally disallowed.

Without documentation of a F2F encounter (and any required prior written order), the claim may be denied as not reasonable and necessary. For hospital beds like E0261, Medicare requires that the F2F encounter occur within 6 months prior to the written order to be valid under DMEPOS requirements.