HCPCS Code E0274: Over-bed table billing guide 2026

Key takeaways

HCPCS code E0274 describes an over-bed table, an accessory to a hospital bed used in the home.

Medicare lists E0274 as noncovered because an over-bed table is not primarily medical in nature.

Suppliers submit noncovered E0274 claims with the GY modifier, which shifts liability to the patient.

Medicare Advantage, Medicaid, and commercial plans set their own rules, so some of them do pay.

Practice management software like Pabau keeps orders, notes, and insurance claim records in one patient file.

HCPCS code E0274 is the Level II code for an over-bed table, the tray table that swings across a hospital bed. Medicare does not pay for it. CMS policy article A52508 lists an over-bed table as noncovered because the item is not primarily medical in nature.

That single line changes the whole billing workflow. You submit the claim with a GY modifier and offer the patient a voluntary notice. Then you check whether another payer covers the item.

The Centers for Medicare and Medicaid Services (CMS) maintains HCPCS Level II and updates the code set through the year. So check the descriptor and payment status before you bill.

This guide covers descriptor, the source of the noncoverage rule, and how to bill E0274 anyway. It also covers what to document, which payers may pay, and the related hospital bed codes.

HCPCS code E0274: Definition and code details

E0274 describes an over-bed table used in the home with a hospital bed. The table gives a bed-confined patient a stable surface for meals, reading, or a laptop.

It sits in the E0250-E0373 hospital bed and accessory range, inside the wider E0100-E0599 durable medical equipment (DME) series. The AAPC HCPCS Level II reference lists the full E-series groupings if you need to place a neighboring code.

Why Medicare lists E0274 as noncovered

Medicare does not pay for an over-bed table because the item fails the definition of durable medical equipment. DME has to be primarily and customarily used for a medical purpose. A table that holds a meal tray serves comfort and convenience. CMS policy article A52508 names E0274 and E0315 as noncovered for that reason.

The distinction matters because the hospital bed itself is covered. A patient can qualify for a bed under the same policy article and still owe the full price of the table. Suppliers who read the bed’s coverage criteria as covering every accessory get a denial each time.

The exclusion is statutory. Under Medicare Part B, no amount of documentation makes E0274 payable. An appeal on medical necessity grounds will not succeed, because the item was never a Medicare benefit.

What counts as a home for DME purposes

A patient’s home is their own house, an apartment, a relative’s home, an assisted living facility, or an independent living facility. Hospitals, skilled nursing facilities, and nursing homes are excluded, because those settings are already paid to supply equipment.

So an assisted living resident still counts as a home patient for DME purposes. That matters for the hospital bed and its covered accessories. It does not rescue E0274, which stays noncovered wherever the patient lives.

How to bill a noncovered over-bed table

Bill E0274 with the GY modifier when the patient asks you to submit a claim. GY tells Medicare the item is statutorily excluded, so the denial comes back quickly and the patient becomes liable. You are not required to file a claim for a categorically excluded item at all.

Most suppliers file one anyway, because the denial gives the patient a paper trail for a secondary plan. An Advance Beneficiary Notice (ABN) is not mandatory for a statutorily excluded item. Issuing a voluntary ABN is still good practice, since it puts the price in writing before delivery.

Modifiers that apply to E0274

The KX modifier does not belong on an E0274 line. KX attests that a policy’s coverage criteria are met, and there are no criteria to meet on a noncovered item. Save it for the hospital bed codes in the same policy article.

Three errors generate most E0274 adjustments in post-payment review:

• Billing it as a covered accessory. The hospital bed’s coverage criteria do not extend to the table, so the line denies on its own terms.
• Overrunning the rental ceiling. Total RR payments cannot exceed the purchase fee schedule amount. E0274 is classified inexpensive or routinely purchased, so no 13-month capped rental conversion applies.
• Leaving a stale billing address. A patient who moves mid-rental may fall under a different Medicare Administrative Contractor (MAC) jurisdiction.

What the fee schedule says about E0274

E0274 carries a DMEPOS fee schedule amount even though Medicare will not pay it. The figure still matters, because Medicaid programs, Medicare Advantage plans, and some commercial payers price from it. Pull the current amount from the CMS DMEPOS fee schedule files rather than a third-party database.

The code’s payment category is inexpensive or routinely purchased. Under that category the item can be bought or rented, and total rental payments stop at the purchase allowable. Amounts also shift by locality, with geographic adjustments in high-cost areas such as Alaska and Hawaii.

Which payers may cover an over-bed table

Medicare Advantage plans, state Medicaid programs, workers’ compensation carriers, and commercial plans set their own DME rules. Some pay for an over-bed table where Medicare Part B will not. Check the plan’s DME policy and its prior authorization list before you deliver.

A Medicare denial is often the first document a secondary payer asks for. Filing the GY claim early gives the patient that paper without delaying delivery. Practices in direct primary care order home equipment for their own panel. They can set the price expectation at the visit rather than after the invoice arrives.

Documentation to keep on file for E0274

Keep the same records you would keep for a covered item, even though Medicare will not pay. A payer that does cover the table will ask for them, and so will an auditor reviewing the hospital bed on the same claim.

• Physician order. A written order signed and dated by the treating physician, naming the item and the diagnosis. Follow up any verbal order in writing.
• Medical records. Notes describing the patient’s condition, functional limits, and the need for a hospital bed at home.
• Proof of delivery. A signed receipt. The delivery date sets the billing start date and is required on rental claims.
• Patient notice. A voluntary ABN or a written price quote, signed before the item leaves your facility.
• Payer approval. The prior authorization number or reference for any plan that requires one.

Do not chase a Certificate of Medical Necessity. CMS eliminated CMNs and DME Information Forms for all durable medical equipment on January 1, 2023. Claims that still carry CMN data are rejected and returned to the supplier, so the form has no place in a 2026 workflow.

Everything the CMN used to capture still has to exist in the medical record. A face-to-face encounter note is the usual place for it, and a telehealth visit can serve where the plan allows one. Digital intake forms timestamp each signature, so nothing depends on a fax confirmation.

Retention rules outlast the claim. Medicare supplier standards require ordering and referring documentation to be kept for seven years from the date of service. State law can require longer, so check the record retention rules that apply to you. A periodic chart audit catches an undated order before a payer does.

Related HCPCS codes and hospital bed crosswalk

The codes around E0274 behave differently, and knowing which ones are payable saves a wasted appeal. Hospital beds and mattresses are covered when the patient meets the policy criteria. The comfort accessories in the same range are not.

Bill the bed and the table on the same claim as separate lines, with the correct modifier on each. The over-bed table does not bundle into the bed codes, so a separate noncovered line is the right form. Suppliers serving the same bed-confined patient often bill other home supply codes too, such as T4522.

How Pabau keeps orders, notes, and claims in one place

The paperwork behind one equipment order usually lives in four places. The order arrives by fax and the clinical note sits in the chart. The delivery receipt is on paper, and claim status lives in a payer portal. When someone asks for the file, a staff member rebuilds it by hand.

Practice management software like Pabau keeps those records in one patient file. Forms, notes, photos, and correspondence attach to the same record, so the history is one click from the appointment. Pabau’s claims management software handles insurance billing for practices and specialists, tracking each claim from submission to payment.

Pabau is built for a practice’s own insurance billing rather than DMEPOS claim submission. A supplier still bills its equipment claims through its own system. What Pabau holds is the clinical evidence behind the order, which is what a payer or an auditor asks the practice for.

The outcome is a shorter records request. Every document behind the order is retrievable from one screen. Nobody digs through folders, inboxes, and fax confirmations to answer a payer.

Keep orders, notes, and claims in one record

Pabau brings patient records, forms, and insurance claims into one system, so the documentation behind an order is ready when a payer asks for it. Your team stops hunting through folders and inboxes.

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Conclusion

The useful thing to know about E0274 is that no workflow makes Medicare pay it. Once you accept that, the job gets simpler. You quote the table as a cash item, get the notice signed, and file the GY claim only if the patient wants one.

The trade-off worth remembering is that the bed and the table travel together in the patient’s mind. They do not travel together in the fee schedule. Suppliers who separate the two conversations at the point of delivery collect more and argue less.

Where the clinical evidence lives is the part a practice still controls. Book a demo to see how Pabau keeps orders, notes, and insurance claims in one patient record.

Continue your research

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Supporting a patient who stays in bed at home? Caregiver care plan gives you a structure for the daily routine around a home hospital bed.

Not sure where equipment paperwork should live? Medical records management explains how to organize orders, notes, and receipts so nothing is rebuilt by hand.

Still chasing signatures on paper forms? Medical forms management shows how digital intake and clinical forms cut paperwork in a busy practice.

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