HCPCS Code E0240: Bath/shower chair billing guide 2026

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Key takeaways

HCPCS Code E0240 describes a bath/shower chair, with or without wheels, any size, and CMS lists it as non-covered by Medicare

E0240 has no DMEPOS fee schedule amount and no Part B coinsurance, because NCD 280.1 denies bath seats as convenience items

Bill E0240 with the GY modifier when a secondary payer needs a formal Medicare denial, and add GX if you issued a voluntary ABN

The KX modifier is never valid on E0240, since a statutory exclusion has no local coverage criteria to meet

Medicaid, Medicare Advantage supplemental benefits, commercial policies, and self-pay are the routes that actually pay for a shower chair

HCPCS Code E0240 covers a bath/shower chair, with or without wheels, any size. Medicare will not pay for it. CMS treats the chair as a convenience item rather than durable medical equipment, and that classification decides the whole billing path.

This guide covers the official descriptor, the coverage code CMS assigns E0240, and why no fee schedule amount exists. It also walks through the GY modifier route, the payers that do cover bath safety equipment, and the documentation that holds up a self-pay sale.

HCPCS Code E0240: definition and official descriptor

E0240 is an active Level II HCPCS code maintained by the Centers for Medicare and Medicaid Services (CMS). It describes a bath/shower chair, with or without wheels, any size. The code sits in the bathing supplies range E0240 through E0249, part of the HCPCS Level II system.

Active does not mean payable. In the January 2026 alpha-numeric HCPCS file, E0240 carries coverage code M, which means non-covered by Medicare. Its pricing indicator is 00, so Part B does not price the code separately.

The “any size” language in the descriptor is intentional. E0240 covers standard, bariatric, and pediatric shower chairs without a separate code for each variant. Wheels make no difference either, and neither changes the coverage answer.

Medicare coverage: why E0240 is non-covered

Medicare Part B does not cover bath or shower chairs. NCD 280.1, the durable medical equipment reference list, denies bath tub seats and bath tub lifts outright. CMS calls them convenience items that are not primarily medical in nature.

The statutory basis is section 1861(n) of the Social Security Act. An item has to be primarily medical in nature to qualify as durable medical equipment. A shower chair fails that test regardless of how frail the patient is.

That verdict does not move with the diagnosis or the strength of the order. The exclusion does change six things at the claim level.

• No LCD pathway: a statutory exclusion sits outside local coverage determination criteria. No documentation set turns an E0240 claim into a paid one.
• No order unlocks payment: CMS retired certificates of medical necessity for all DME claims in January 2023. The standard written order replaced them, and it cannot make an excluded item payable.
• No fee schedule amount: E0240 has no row in the DMEPOS fee schedule file. There is nothing for Medicare to pay 80% of.
• No 80/20 split: standard Part B coinsurance never applies here. The patient is liable for the full charge.
• The ABN is voluntary: Medicare does not require an Advance Beneficiary Notice for a statutory exclusion. Most suppliers still issue one so the price is in writing.
• Other payers may still pay: Medicaid programs, Medicare Advantage plans, and commercial policies set their own rules for bath safety equipment.

E0240 stays on the DMEPOS jurisdiction list, so any claim you file goes to the DME MAC. The denial comes back as a statutory exclusion rather than a medical necessity failure. Those are different denials with different next steps, and only one of them is worth appealing.

Payers that do cover bath and shower chairs

Non-covered by Medicare is not the same as never paid. Four routes remain open, and each one runs on its own rules.

• Medicaid: many state programs cover bath safety equipment with prior authorization. Minnesota Health Care Programs is one example. Check your state’s DME schedule and authorization form.
• Medicare Advantage: some plans add supplemental or over-the-counter benefits that include bath safety items. The benefit sits outside original Medicare, so confirm it plan by plan.
• Commercial plans: coverage follows each plan’s own medical policy. Aetna’s Clinical Policy Bulletin 0429 treats a standard bath or shower chair as a convenience item. It reserves medical necessity coverage for complex positioning bathing systems.
• Self-pay: most patients buy the chair outright. Quote the price before delivery and document the conversation.

Verify the benefit before the chair leaves the shelf. A benefits check takes minutes, while a chair delivered against a benefit that does not exist costs the practice the full price.

E0240 reimbursement in 2026: what Medicare pays

Nothing. E0240 has no allowed amount in the 2026 DMEPOS fee schedule and no locality-based rate behind it. The pricing indicator 00 says Part B does not price the code at all.

That also rules out the lookup tools billers reach for by habit. The physician fee schedule search does not price DMEPOS items. The DMEPOS fee schedule does, and E0240 is absent from the file.

Modifiers used with E0240

On a statutorily excluded item, modifiers tell Medicare that you expect the denial and why you filed anyway. Two of them do almost all the work on this code.

GY is the modifier that matters. It produces a clean statutory denial, which is what a Medicaid or commercial secondary plan wants to see before it pays. A shower chair is also sold rather than rented, so rental modifiers rarely belong on the claim line.

KX is the error to watch for. It asserts that criteria in an active local coverage determination have been met, and no such determination exists for E0240. Strip it out of any claim template that still carries it.

Documentation that supports an E0240 charge

Medicare offers no documentation pathway for E0240, so the paperwork serves two other purposes. It satisfies whichever payer might cover the chair, and it protects the practice when the patient pays.

• Written order: signed and dated by the treating practitioner before delivery. Medicaid and commercial plans still ask for one.
• Advance Beneficiary Notice: voluntary for a statutory exclusion. Issue it anyway and bill with GX, so the patient’s liability is documented.
• Supporting records: clinical notes, therapy evaluations, or a home assessment describing the functional limitation. Non-Medicare payers review these.
• Proof of delivery: a signed receipt listing the item and the HCPCS code. Keep it for audits and billing disputes.
• Prior authorization: many Medicaid programs require it before delivery. Get the authorization number on file first.

ICD-10 codes that support the functional limitation

A diagnosis code will not make Medicare pay for E0240. It matters for the payers that do cover bath safety equipment, and for the record behind a self-pay sale. The codes below are illustrative examples rather than a coverage guarantee. Use the CDC/NCHS ICD-10-CM web tool to confirm current code status before you submit.

Related HCPCS codes in the E0240-E0249 bathing supplies range

The E0240 through E0249 range covers bathing and bathroom safety equipment. Coding accuracy still matters on a non-covered item, because the code has to match what you delivered. Check the current HCPCS quarterly update file for full descriptor language and coverage codes before you choose between adjacent codes.

E0245 and E0247 are the codes most often confused with E0240. If part of the item extends over the tub edge to allow a lateral transfer, E0247 is usually correct. If the item is a seated chair placed inside the shower or tub, E0240 applies.

E0240 vs E0163: what a covered code looks like

Billers often assume every E-series item works the same way. Setting E0240 next to a commode chair shows how far apart two neighboring codes can sit.

E0163 covers a commode chair with fixed arms, mobile or stationary, and it carries coverage code D. That letter means special coverage instructions apply. It has rows in the DMEPOS fee schedule, so an allowed amount, coinsurance, and a medical necessity review all exist.

E0240 carries coverage code M and no fee schedule row at all. Same code series, opposite billing path. Set side by side, the two codes split on every mechanic of the claim.

That is the check worth building into your process. Read the coverage code before you build any DME claim, because one letter tells you whether documentation can change the outcome.

How to bill E0240: step-by-step

The workflow below assumes the patient wants the chair and Medicare is somewhere in the picture. The point is to remove the surprises before delivery rather than after the denial.

1. Confirm the item matches E0240. A transfer bench is E0247 and a tub stool is E0245. Coding accuracy still matters on a non-covered item.
2. Check the patient’s plan type. Original Medicare will deny. A Medicare Advantage plan, a state Medicaid program, or a commercial policy may cover the chair, so verify benefits first.
3. Collect the written order and supporting notes. Non-Medicare payers ask for both, and the record supports the sale either way.
4. Secure prior authorization if the covering payer requires it. Many state Medicaid programs do. Record the authorization number before delivery.
5. Issue an ABN and quote the price. The notice is voluntary here. It puts the patient’s liability in writing before the chair leaves the shelf.
6. Deliver the chair and collect proof of delivery. The signed receipt should name the item and list the HCPCS code. Auditors ask for this document first.
7. File the claim to the right payer. Bill Medicare with GY, plus GX for a voluntary ABN, only when a secondary plan needs the denial. Otherwise bill the covering payer or the patient.
8. Post the outcome and collect the balance. Expect a statutory denial from the DME MAC, then move the balance to the secondary payer or the patient’s account.

Common billing errors and denials for E0240

Denials on this code cluster around one assumption. Billers treat E0240 as a covered DME item, and the table below shows what that produces. The denial codes in medical billing guide maps CARC and RARC interpretation in detail.

How Pabau keeps non-covered charges clean

A non-covered item creates work at the front desk rather than in the claim scrubber. Someone has to quote a price, collect a signature, and take the payment. Practice management software like Pabau keeps those three steps on one patient record.

Pabau’s claims management software files the Medicare claim when a secondary payer needs the denial, and records what came back. Pabau’s digital forms hold the written order, the ABN, and the delivery sign-off against the same patient.

Checkout closes the loop. The chair gets invoiced, the patient pays, and the balance stops sitting in an unassigned bucket. Your billers spend their time on the claims that can actually be paid.

Keep every non-covered supply charge accounted for

Pabau’s claims management and digital forms hold the written order, the ABN, and the delivery receipt on one patient record. Your team can quote a price, collect it at checkout, and file a Medicare denial when a secondary payer needs one.

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Conclusion

E0240 is a code you use, not a code you get paid on. Medicare classifies a bath or shower chair as a convenience item, so there is no fee schedule amount and no medical necessity review to win.

That makes the workflow shorter than most DME billing. Bill GY when a secondary payer needs the denial on record. Check Medicaid and Medicare Advantage benefits before you call the patient self-pay, and put the price in writing first.

Book a demo to see how Pabau ties supply charges to the order, the notice, and the payment behind them.

Continue your research

Billing a commode chair instead? E0163 shows what the documentation looks like on a code Medicare actually covers.

Want to understand how clean claim submission reduces denials? Clean claim standards explains what makes a claim pass initial payer edits and reach adjudication.

Looking for a reference on DMEPOS denial codes and how to respond? Denial codes in medical billing maps common CARC and RARC codes to the right correction.

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