HCPCS E0242 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Durable Medical Equipment • Bathing Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS E0242 by major payers:

$38.05

$34.25

$34.19

$62.07
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS E0242 | ||||||
United | E0242 | $82.16 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $29.60 | 1841651056 - KAMRAN RAJAEE | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $29.65 | 1093753386 - WILLAMETTE COMMUNITY HEALTH SOLUTIONS, CASCADE HEALTH SOLUTIONS | 930421470 | OR | Community Based Hospice Care Agency (251G00000X) |
United | E0242 | $74.58 | 1598964082 - EMORY HEALTHCARE | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $28.42 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $74.58 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $38.70 | 1104286418 - PHOENIX VAMC | 860101019 | AZ | Psychiatric Residential Treatment Facility (323P00000X) |
United | E0242 | $34.06 | 1326191180 - PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC, MOUNTAIN LAKES MEDICAL CENTER | 202012765 | GA | Critical Access Hospital (282NC0060X) |
United | E0242 | $29.53 | 1326079260 - HOSPITAL AUTHORITY OF LIBERTY COUNTY, LIBERTY REGIONAL MEDICAL CENTER | 586025016 | GA | Critical Access Hospital (282NC0060X) |
United | E0242 | $123.67 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | E0242 | $34.06 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | E0242 | $38.70 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $27.97 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | E0242 | $46.08 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | E0242 | $41.47 | 1720098791 - IRWIN COUNTY HOSPITAL | 586003765 | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS E0242 vs. Other Bathing Supplies Codes
The HCPCS E0242 code is part of the Durable Medical Equipment services used for Bathing 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 E0242 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.
| Code | Complexity | Description |
|---|---|---|
| E0241-HCPCS | Low | Bath tub wall rail, each |
| E0242-HCPCS | Low | Bath tub rail, floor base |
| E0243-HCPCS | Low | Toilet rail, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0242. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E0242 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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