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A hospital bed mattress is the support surface that sits on a hospital bed frame. In U.S. rules it is regulated and, for Medicare, grouped separately from the bed itself and from any cover. This page explains the main mattress classes, the FDA class that applies to the powered type, and how Medicare names its support-surface groups.
This page describes products and general use; it is not medical advice.
Who uses it: clinic and facility staff, medical-supply buyers and students who need to tell a standard mattress from a powered pressure-reducing surface and to read the regulatory and coverage language correctly.
What a hospital bed mattress is
A hospital bed mattress is the surface a patient lies on in a hospital bed. It is a separate product from the bed frame (the motorised or manual bed, see what a hospital bed is and hi-lo beds) and from a protective cover. Covers have their own page: vinyl mattress covers explains cover materials, regulation and care, so this page does not repeat it.
How the powered type is built
The FDA regulation for the alternating pressure air flotation mattress (21 CFR 880.5550) describes it as a mattress with multiple air cells that can be filled and emptied in an alternating pattern by an associated control unit, to provide regular, frequent and automatic changes in the distribution of body pressure. The two named parts are therefore the air cells and the control unit.
Types and variants
The table lists the product classes named in U.S. federal sources and what each source states, and nothing more.
| Type | What the source says | Source |
|---|---|---|
| Alternating pressure air flotation mattress | Multiple air cells filled and emptied in an alternating pattern by a control unit to change body-pressure distribution. | 21 CFR 880.5550 |
| Group 1 mattress overlay or mattress (Medicare) | A Medicare coverage category titled “Pressure Reducing Support Surfaces – Group 1”. | CMS LCD L33830 |
| Group 2 support surface (Medicare) | A separate Medicare coverage category with its own policy. | CMS LCD L33642 |
| Group 3 air-fluidized bed (Medicare) | A bed, not a mattress, with its own policy. | CMS LCD L33692 |
For a side-by-side of two powered mattress types, see alternating pressure mattress vs low air loss mattress.
FDA class: mattress versus bed
FDA assigns a device class by device type. The class tells you how much regulatory control applies, not how well a given product performs.
| Device type | FDA class | Premarket notification | Source |
|---|---|---|---|
| Alternating pressure air flotation mattress | Class II (special controls) | Exempt, subject to 21 CFR 880.9 | 21 CFR 880.5550 |
| AC-powered adjustable hospital bed (built-in electric motor and remote controls, adjustable height and surface contour, movable and latchable side rails) | Class II (special controls) | Exempt, subject to 21 CFR 880.9 | 21 CFR 880.5100 |
| Manual adjustable hospital bed (manual mechanism operated by an attendant, movable and latchable side rails) | Class I (general controls) | Exempt, subject to the limitations in 21 CFR 880.9 | 21 CFR 880.5120 |
Medicare support-surface groups
Medicare publishes separate coverage policies (Local Coverage Determinations) for three groups of support surfaces: Group 1 (mattress overlay or mattress, L33830), Group 2 (L33642) and Group 3, an air-fluidized bed (L33692). Each policy sets its own coverage criteria for payment; these are not clinical guidance on which surface any patient should use. Read the current policy text for the criteria, and leave surface selection to a clinician.
Safe use and handling basics
Follow the manufacturer’s instructions for use for the specific mattress and its control unit, and the facility’s own policies. Cleaning and cover questions are covered in vinyl mattress covers. Bed dimensions are covered in adjustable bed dimensions. For the wider context on pressure injuries, see the pressure injury prevention programme guide.
Common mistakes
- Treating the mattress, the cover and the bed frame as one product. They are separate products with separate FDA regulations and, for Medicare, separate policies.
- Reading a Medicare group as a clinical ranking. Each group is a set of coverage criteria for payment.
- Assuming a Group 3 item is a mattress. The Group 3 policy covers an air-fluidized bed.
FAQ
What FDA class is a hospital bed mattress?
The alternating pressure air flotation mattress is Class II (special controls) under 21 CFR 880.5550 and is exempt from premarket notification, subject to 21 CFR 880.9.
Is a hospital mattress cover the same product as the mattress?
No. The cover is a separate product; see vinyl mattress covers.
Does Medicare treat the mattress and the bed differently?
Yes. Group 1 covers a mattress overlay or mattress, while the Group 3 policy covers an air-fluidized bed.
Sources
- FDA, 21 CFR 880.5550 Alternating pressure air flotation mattress: https://www.ecfr.gov/current/title-21/section-880.5550 (checked 2026-10-30)
- FDA, 21 CFR 880.5100 AC-powered adjustable hospital bed: https://www.ecfr.gov/current/title-21/section-880.5100 (checked 2026-10-30)
- FDA, 21 CFR 880.5120 Manual adjustable hospital bed: https://www.ecfr.gov/current/title-21/section-880.5120 (checked 2026-10-30)
- CMS Medicare Coverage Database, LCD L33830 (Group 1): https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33830 (checked 2026-10-30)
- CMS Medicare Coverage Database, LCD L33642 (Group 2): https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33642 (checked 2026-10-30)
- CMS Medicare Coverage Database, LCD L33692 (Group 3): https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33692 (checked 2026-10-30)
