HCPCS E0196 Fee Schedule

HCPCS E0196 vs. Other Pressure Mattresses, Pads, and Other Supplies Codes

The HCPCS E0196 code is part of the Durable Medical Equipment services used for Pressure Mattresses, Pads, and Other Supplies. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS E0196 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0196. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the E0196 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.