DME Billing with E-Codes: DMEPOS Fee Schedule Guide

E-codes are the HCPCS Level II section covering durable medical equipment (DME) — wheelchairs, hospital beds, walkers, canes, crutches, and similar items. They are billed by DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) suppliers enrolled with Medicare. Browse E-codes by filtering the code browser by E. Payment rates for these codes come from the DMEPOS fee schedule.

The DMEPOS fee schedule is updated quarterly by CMS. It includes separate amounts for different transaction types: rental (modifier RR), purchase of new equipment (modifier NU), and purchase of used equipment (modifier UE). Some equipment has both a rental and a purchase option, while other items may only be covered under one payment type. Billers must apply the correct modifier to trigger the appropriate rate.

Medicare requires a Certificate of Medical Necessity (CMN) or detailed written order (DWO) for many DMEPOS items before a claim can be submitted. Items classified as "assigned" must be accepted at Medicare's approved amount, meaning the supplier cannot balance bill the beneficiary for the difference. DMEPOS suppliers that are not enrolled in Medicare are prohibited from billing the program entirely.

Prior authorization requirements have expanded for certain high-cost DME items — specifically power wheelchairs and certain respiratory equipment. Before billing these items, suppliers should confirm prior authorization status. Check the quarterly update log for changes to coverage criteria or fee schedule amounts that affect DME categories.