E0250 Hosp bed fixed ht w/ mattresHospital bed, fixed height, with any type side rails, with mattress
7 of 7 payer prior-auth lists that name E0250 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Humana, Medicare, Rocky Mountain Health Plans, UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | AZ Blue-administered Medicare Advantage (M2K) | AZ | prior auth required | Sep 1, 2026 | AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Effective 09/01/2026) | |
| Medicare | DMEPOS Master List (items potentially subject to PA) | All | prior auth under conditions | On the Master List; PA only if CMS selects it for the Required List | Jul 30, 2026 | Master List of DMEPOS Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements |
| Humana | Humana Healthy Horizons | KY | prior auth required | Jan 1, 2027 | please visit Humana Healthy Horizons in Kentucky Clinical coverage policies. | |
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 | |
| UnitedHealthcare Community Plan | AHCCCS Complete Care (ACC) | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026 | |
| UnitedHealthcare Community Plan | ALTCS Developmentally Disabled | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | New Mexico Turquoise Care | NM | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of New Mexico Effective October 1, 2026 |
E0250 appears in 17 coverage policies from Aetna, Anthem, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Hospital Beds and Accessories (0543) | covered if criteria are met | Sep 23, 2026 | payer document |
| Anthem | Hospital Beds and Accessories (CG-DME-15) | covered if criteria are met (range E0250-E0251) | Feb 19, 2026 | payer document |
| Capital Blue Cross | Hospital Beds and Accessories (MP 6.001) Procedure codes | covered if criteria are met | Mar 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hospital Beds and Related Equipment (DME101.001) HCPCS Codes A4640, E0181, E0182, E0183, E0184, E0185, E0186, E0187, E0188, E0189, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Hospital Beds and Accessories | listed, no stance | Jan 12, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (MP.028.15) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (CS181.I) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Idaho Only) (CS181ID.D) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Kansas Only) (CS181KS.02) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Kentucky Only) (CS181KY.10) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Nebraska Only) (CS181NE.I) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for New Jersey Only) (CS181NJ.H) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for New Mexico Only) (CS181NM.C) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for North Carolina Only) (CSNC.MP.100.08) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Ohio Only) (CS181OH.F) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Pennsylvania Only) (CS181PA.I) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Beds and Mattresses (for Tennessee Only) (CS181TN.H) | listed, no stance | Sep 1, 2026 | payer document |
Prior authorization required or conditional in CO, FL, IL, IN, KY, LA, MA, MS, ND, NE, OH, VA, WV, WY.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.