HCPCS code E0244: Raised toilet seat billing guide

Key Takeaways

HCPCS code E0244 describes a raised toilet seat, a durable medical equipment (DME) item in the HCPCS Bathing Supplies range E0240-E0249.

Medicare does not cover E0244; it is classified as non-covered per CMS Policy Article A52461. Bill with the GY modifier for Medicaid crossover or liability purposes.

State Medicaid programs vary: Medi-Cal’s DME provider manual generally cites a once-every-5-years frequency limit for E0244; MassHealth’s current DME and Oxygen Payment and Coverage Guideline Tool addresses NU and UD modifier use for the code.

Pabau’s claims management software supports modifier attachment and claim submission workflows, reducing manual errors on non-covered DME codes.

HCPCS code E0244 is the billing code for a raised toilet seat, a durable medical equipment (DME) item in the HCPCS Bathing Supplies range E0240-E0249. Medicare classifies it as non-covered, so claims need the GY modifier attached or they reject at the payer level.

This guide covers the code definition, Medicare’s non-coverage rule, GY modifier requirements, DME fee schedule data, and how Medi-Cal and MassHealth handle the code under their own Medicaid policies. Claims management software that flags non-covered DME codes at entry reduces this type of denial.

HCPCS code E0244: Definition and code properties

HCPCS code E0244 describes a raised toilet seat, classified under the HCPCS Level II Bathing Supplies range E0240-E0249. The code’s short descriptor is “Toilet seat raised.” It applies to adaptive DME devices designed to increase toilet height, making sitting and standing easier for patients with mobility limitations, joint weakness, post-surgical restrictions, or lower-extremity strength deficits.

E0244 sits within a cluster of toilet and bathing assist codes. Understanding the differences between adjacent codes is essential for accurate selection.

• E0243 (Toilet rail, each): A safety rail that attaches to the toilet for grip support. Not a raised seat. Billed per rail.
• E0244 (Raised toilet seat): A seat that elevates toilet height. Non-covered by Medicare.
• E0245 (Tub stool or bench): A seating device used inside the bathtub or shower. Separate clinical indication from E0244.
• E0246 (Transfer tub rail attachment): A rail attached to the tub edge to assist transfers. Not interchangeable with E0244.
• E0247 (Transfer bench, tub/toilet/commode opening): A bench spanning the tub or toilet that allows seated transfers. Different device class.

Selecting E0243 or E0245 when the item supplied is actually a raised toilet seat is a coding error that misrepresents the equipment delivered and may lead to audit risk. Other mobility DME, such as HCPCS code E0100 (cane), follows its own separate coverage and documentation rules and should not be confused with E0244.

Medicare coverage status and the GY modifier

Medicare does not cover HCPCS code E0244. Per CMS Policy Article A52461 (Commodes), a raised toilet seat is explicitly listed as a non-covered item, the same broad category covered in the HCPCS code A9270 non-covered item billing guide. This applies regardless of medical necessity documentation or physician order.

The same non-coverage status extends to a commode chair used as a raised toilet seat. When a supplier positions a commode chair over the toilet instead of providing a standalone raised seat, CMS treats the item as functionally equivalent to E0244. The GY modifier must be added to the commode chair code in that scenario.

When to use the GY modifier

The GY modifier signals that an item is statutorily non-covered or does not meet the definition of a Medicare benefit. For E0244, the GY modifier applies when:

• Billing a Medicare/Medicaid crossover claim where Medicare denial documentation is required for Medicaid processing.
• A beneficiary has signed an Advance Beneficiary Notice (ABN) and the supplier needs to establish liability for the non-covered item.
• A commode chair (separately covered under Medicare) is being billed in the context of raised-toilet-seat positioning per CMS Policy Article A52461.

Without the GY modifier, a Medicare claim for a non-covered item will typically reject at the payer level rather than produce a formal denial, which can delay the Medicaid secondary billing process. Automated billing workflows that attach required modifiers based on code type reduce this delay significantly.

DME fee schedule for HCPCS code E0244

Because Medicare classifies E0244 as non-covered, the standard Medicare DME fee schedule does not apply for Medicare payment purposes. However, fee schedule data is still relevant for:

• Setting Medicaid billing amounts in states that use Medicare fee schedule crosswalks.
• Establishing a baseline for commercial payer contracts that reference DME fee schedules.
• Documenting the usual and customary charge when billing a beneficiary directly.

Published fee schedule data for E0244 varies by DME MAC jurisdiction and by year. For the most current figures, reference the official HCPCS E0244 code data alongside the CMS DME fee schedule files published annually on cms.gov. Fee schedules are updated each January 1 and may be adjusted mid-year for geographic adjustments.

The same reference approach applies to other non-covered or state-variable DME codes, such as HCPCS code E0673 (pneumatic appliances) and HCPCS code L1906 (ankle foot orthosis). Suppliers billing state Medicaid programs should reference each state’s DME fee schedule directly, as Medicaid reimbursement rates for E0244 are set independently of the Medicare fee schedule.

State Medicaid coverage: Medi-Cal and MassHealth

While Medicare does not cover E0244, state Medicaid programs may cover the code under their own DME benefit policies. Coverage rules, frequency limits, and modifier requirements differ by state.

Medi-Cal (California)

Medi-Cal’s DME provider manual lists a frequency limit for HCPCS code E0244, generally cited as once every 5 years, though suppliers should confirm the current figure directly with Medi-Cal before submission. This limit applies across all adjacent bathing supplies codes in the E0240-E0249 range.

Claims submitted before the frequency window has elapsed will deny. Document the last date of service for E0244 in the structured client record to prevent premature resubmission.

MassHealth (Massachusetts)

MassHealth (Massachusetts Medicaid) permits billing E0244 with NU and UD modifiers. MassHealth has updated its DME modifier guidance multiple times since the original 2005 DME-26 transmittal, through DME-46 in 2024, so the modifiers below should be confirmed against current guidance rather than the original transmittal:

• NU modifier: New equipment. Use when billing for a newly purchased raised toilet seat.
• UD modifier: Used durable medical equipment. Use when the item provided is a used or refurbished raised toilet seat.

Applying the wrong modifier (or omitting it) on a MassHealth E0244 claim will produce a rejection. Confirm current modifier requirements using MassHealth’s DME and Oxygen Payment and Coverage Guideline Tool before submission.

Other state Medicaid programs

Coverage for E0244 across other state Medicaid programs is not uniform. Some states follow Medicare’s non-coverage status; others provide limited DME coverage for toilet assist devices under home health or personal care benefit categories.

This same state-by-state variation shows up in codes like HCPCS code E2607 (wheelchair cushion), where coverage and documentation rules also differ from one Medicaid program to the next.

Always verify the specific state’s DME fee schedule and coverage policy directly with the state Medicaid agency before submitting a claim. Patient care management documentation that captures the prescribing clinician’s order and diagnosis helps satisfy state Medicaid prior authorization requirements where applicable.

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Documentation requirements for HCPCS E0244

Because Medicare does not cover E0244, Medicare’s standard medical necessity documentation requirements do not generate payment, but documentation still matters for three reasons: Medicaid billing, commercial payer adjudication, and liability protection when the patient is billed directly.

For state Medicaid programs that do cover E0244, standard DME documentation requirements typically include:

• A written order from a licensed prescriber (physician, nurse practitioner, or physician assistant) dated before the equipment is provided.
• A diagnosis code supporting functional limitation that necessitates the raised toilet seat (typically a mobility-limiting diagnosis such as osteoarthritis, hip fracture recovery, lower-extremity weakness, or post-surgical hardware complications that restrict mobility).
• Documentation of the patient’s functional limitations in the clinical note, such as a 12-item short form survey, including inability or difficulty with standard toilet height.
• Supplier delivery confirmation and beneficiary acknowledgment.

Using digital forms for clinical documentation allows prescribing clinicians to capture functional limitation data in a structured format that maps directly to the billing record. This reduces the documentation-to-claim turnaround and ensures required fields are not missed.

Related HCPCS codes and crossover billing

Understanding how E0244 relates to adjacent codes helps suppliers select the most appropriate code and avoid upcoding or undercoding.

All codes in the E0240-E0249 Bathing Supplies range are non-covered by Medicare, per the AAPC HCPCS Bathing Supplies code range reference. State Medicaid coverage varies by code and by state, so each code must be verified independently.

When a patient carries both Medicare and Medicaid (a dual-eligible beneficiary), the billing sequence is: submit to Medicare first, receive the non-coverage denial with GY modifier, then submit to Medicaid as secondary payer with the Medicare denial documentation attached.

Medical forms workflows that generate the required denial documentation automatically within the billing record speed this crossover process.

Billing workflow for HCPCS code E0244 in practice

For DME suppliers and practices that provide or prescribe raised toilet seats, a reliable billing workflow reduces both denial rates and manual rework. The steps below outline a practical E0244 billing process for suppliers dealing with Medicare beneficiaries and dual-eligible patients.

1. Obtain a written order from the prescribing clinician before providing the item, noting the diagnosis and functional limitation.
2. Verify the patient’s coverage, including Medicare Part B status and any supplemental or Medicaid coverage.
3. Enter code E0244 in the billing system. If the patient’s state Medicaid program covers the code, attach the appropriate modifier (NU for new equipment; UD for used equipment in states requiring it).
4. Attach the GY modifier if billing Medicare for a commode chair used in a raised-toilet-seat configuration, or for dual-eligible crossover billing.
5. Submit to Medicare (where applicable) and collect the non-coverage denial response.
6. Submit to Medicaid secondary with Medicare denial attached, following state-specific crossover billing rules.
7. Track claim outcomes using denial reports to identify patterns (for example, frequency limit denials in Medi-Cal claims) and adjust workflow accordingly.

Integrated practice management workflows that link clinical documentation, modifier rules, and claim submission in one system reduce the manual steps in this sequence and make crossover billing for non-covered DME codes more consistent.

For practices managing multiple DME codes alongside clinical appointments, medical practice management tools that support HCPCS Level II billing natively reduce coding errors across the full DME portfolio.

Continue your research

Billing another non-covered DME item? The HCPCS code A9270 (non-covered items) guide explains how the GY modifier and statutory non-coverage rules apply across the wider DME category.

Want to automate modifier attachment? Automated workflows software can flag codes like E0244 at data entry and apply the correct GY, NU, or UD modifier before the claim goes out.

Comparing platforms for DME and clinical billing? Our roundup of the best medical practice management software reviews tools that handle HCPCS Level II billing alongside scheduling and records.

Conclusion

HCPCS code E0244 carries a deceptively simple description but a billing workflow that catches many suppliers off guard. Medicare’s non-coverage status means claims without the GY modifier will reject, Medicaid frequency limits create recurring denial patterns, and crossover billing for dual-eligible patients requires documentation to be in place before submission, not after.

Pabau’s claims management software supports modifier attachment, claim outcome tracking, and documentation-to-billing workflows that keep non-covered DME code submissions clean. To see how it works in a live practice environment, book a demo.

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