The HCPCS code E0194 is used for a powered air flotation bed (low air loss therapy) designed to prevent and treat pressure ulcers in patients confined to bed for extended periods. Billing this item correctly requires precise documentation, accurate modifiers, and adherence to Medicare DMEPOS and LCD guidelines.

This guide explains how to bill E0194 efficiently, covering documentation requirements, modifiers, payer policies, and best practices to ensure compliance and timely reimbursement.

What Is HCPCS Code E0194?

HCPCS Code E0194 refers to a powered air flotation bed (low air loss therapy) billed on a per-day rental basis. This bed is designed to help patients prevent or treat pressure ulcers and skin breakdown by maintaining constant airflow and pressure redistribution.

It falls under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) category and is covered by Medicare Part B when medically necessary. The item is primarily used for patients confined to bed who require continuous skin protection due to immobility or chronic wounds.

Required Documentation for E0194 Billing

Accurate documentation is essential for billing E0194 successfully and avoiding claim denials. Since this code represents a rental item, each billing cycle must be supported by updated records proving medical necessity, delivery, and patient condition. Payers such as Medicare, Medicaid, and private insurers require a complete documentation set before reimbursement is issued.

Below are the core documents required for E0194 claim submission:

According to CMS DMEPOS guidelines, missing DWO or F2F documentation accounts for over 40% of denials for hospital bed-related DME claims.

Correct Modifiers for E0194

Modifiers help clarify how HCPCS code E0194 should be billed and reimbursed. Since this code represents a rental-only item, selecting the correct modifier ensures proper claim processing and prevents payer rejections. Incorrect or missing modifiers often lead to payment delays or partial reimbursements under Medicare Part B.

Below are the modifiers commonly used for E0194 claims:

Always bill E0194 with the RR modifier and attach KX only when documentation fully meets Medicare’s medical necessity and coverage criteria.

Common Billing Errors to Avoid

Billing E0194 requires precision in documentation, modifier selection, and claim frequency. Even minor inconsistencies can result in denials or payer audits. Many rejections occur when DME suppliers fail to provide supporting medical records or use incorrect rental billing intervals.

Here are the most frequent E0194 billing errors:

• Missing or unsigned Detailed Written Order (DWO). 
• No Face-to-Face (F2F) encounter within the required six-month period. 
• Failing to attach the RR and KX modifiers when applicable. 
• Incorrect billing period (e.g., billing monthly instead of daily). 
• Submitting claims without Proof of Delivery (POD). 
• Using a diagnosis unrelated to pressure ulcers or wound care needs. 

CMS audits show that over 35% of denied DME claims result from incomplete documentation or missing modifier combinations.

Medicare Reimbursement Guidelines for E0194

Under Medicare Part B, E0194 is classified as a capped rental item reimbursed on a per-day basis. Payment is authorized when documentation confirms medical necessity and the patient meets clinical criteria for low air loss therapy.

To qualify for Medicare reimbursement:

• The patient must have stage II or higher-pressure ulcers on multiple body areas. 
• The physician must document that standard support surfaces failed to improve the condition. 
• The supplier must provide F2F documentation, a valid DWO, and Proof of Delivery (POD). 
• The equipment must be used in the patient’s home setting and meet DMEPOS supplier standards. 

Reimbursement rates for E0194 vary by geographic region and payer jurisdiction, as listed in the CMS DMEPOS Fee Schedule. Suppliers should verify local coverage determinations (LCDs) and policy articles (PAs) before billing to ensure compliance.

According to CMS policy, payment for E0194 continues only while medical necessity is documented and the patient’s condition justifies ongoing therapy.

How QHS Ensures Accurate E0194 Billing

Quality Healthcare Systems (QHS) delivers end-to-end DME billing services in High Point, North Carolina, with specialized expertise in powered air flotation and wound care equipment billing. Our certified team ensures compliance, documentation accuracy, and faster reimbursements for suppliers managing complex DME codes like E0194.

We handle every aspect of the billing process, from prior authorization and DWO management to modifier validation and denial prevention. QHS continuously monitors Medicare and Medicaid policy updates to align claims with the latest DMEPOS coverage requirements.

With over 98% clean claim accuracy, QHS helps DME suppliers reduce administrative workload, lower AR days, and maintain full regulatory compliance.

Frequently Asked Questions

What is HCPCS code E0194 used for?

HCPCS code E0194 refers to a powered air flotation bed (alternating pressure), typically used for patients with pressure ulcers who require advanced support surfaces to prevent further tissue damage.

How is E0194 billed under Medicare?

E0194 is billed as a rental item under Medicare Part B using the RR modifier, and reimbursement is calculated per day when all medical necessity and documentation criteria are met.

Which modifiers are required for E0194 billing?

The RR (rental) modifier is mandatory for all E0194 claims. Use the KX modifier when medical necessity documentation is complete and compliant with Medicare DMEPOS requirements.