E0191 — Heel or elbow protector, each
HCPCS Level II E-code · short descriptor: “Protector heel or elbow”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Inexpensive or routinely purchased
- Prior authorization
- Not on Medicare required-PA list
- Face-to-face & WOPD
- Not on the required list
- Status
- Active (HCPCS Level II October 2026)
Prior authorization
Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
Order readiness — what the written order must contain
Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):
- Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
- General description of the item (42 CFR 410.38(d)(1)(i)(B))
- Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
- Order date (42 CFR 410.38(d)(1)(i)(D))
- Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
- Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))
Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.
Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.
E0191 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $12.10 to $18.08 depending on state and rural status.
Former-CBA payment limits: ceiling $14.24 · floor $12.10
| State | Non-rural | Rural |
|---|---|---|
| AK | $12.48 | — |
| AL | $14.24 | — |
| AR | $13.35 | — |
| AZ | $12.10 | — |
| CA | $12.33 | — |
| CO | $14.24 | — |
| CT | $12.10 | — |
| DC | $14.24 | — |
| DE | $14.24 | — |
| FL | $13.17 | — |
| GA | $12.10 | — |
| HI | $13.34 | — |
| IA | $12.10 | — |
| ID | $14.24 | — |
| IL | $14.24 | — |
| IN | $13.16 | — |
| KS | $12.10 | — |
| KY | $14.24 | — |
| LA | $13.70 | — |
| MA | $14.24 | — |
| MD | $14.24 | — |
| ME | $14.24 | — |
| MI | $14.24 | — |
| MN | $13.16 | — |
| MO | $12.10 | — |
| MS | $13.68 | — |
| MT | $14.24 | — |
| NC | $12.10 | — |
| ND | $14.24 | — |
| NE | $12.10 | — |
| NH | $14.24 | — |
| NJ | $14.24 | — |
| NM | $14.24 | — |
| NV | $12.10 | — |
| NY | $12.10 | — |
| OH | $14.17 | — |
| OK | $14.24 | — |
| OR | $12.10 | — |
| PA | $14.24 | — |
| PR | $18.08 | — |
| RI | $14.24 | — |
| SC | $12.10 | — |
| SD | $14.24 | — |
| TN | $12.10 | — |
| TX | $13.34 | — |
| UT | $14.24 | — |
| VA | $14.24 | — |
| VI | $12.10 | — |
| VT | $14.24 | — |
| WA | $12.10 | — |
| WI | $14.24 | — |
| WV | $14.17 | — |
| WY | $14.24 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $1.24 to $2.23 depending on state and rural status.
Former-CBA payment limits: ceiling $1.47 · floor $1.25
| State | Non-rural | Rural |
|---|---|---|
| AK | $1.24 | — |
| AL | $1.47 | — |
| AR | $1.34 | — |
| AZ | $1.47 | — |
| CA | $1.25 | — |
| CO | $1.47 | — |
| CT | $1.25 | — |
| DC | $1.47 | — |
| DE | $1.47 | — |
| FL | $1.31 | — |
| GA | $1.25 | — |
| HI | $1.34 | — |
| IA | $1.25 | — |
| ID | $1.47 | — |
| IL | $1.47 | — |
| IN | $1.31 | — |
| KS | $1.25 | — |
| KY | $1.47 | — |
| LA | $1.36 | — |
| MA | $1.47 | — |
| MD | $1.47 | — |
| ME | $1.47 | — |
| MI | $1.25 | — |
| MN | $1.31 | — |
| MO | $1.25 | — |
| MS | $1.36 | — |
| MT | $1.47 | — |
| NC | $1.25 | — |
| ND | $1.47 | — |
| NE | $1.25 | — |
| NH | $1.47 | — |
| NJ | $1.47 | — |
| NM | $1.47 | — |
| NV | $1.47 | — |
| NY | $1.25 | — |
| OH | $1.47 | — |
| OK | $1.47 | — |
| OR | $1.25 | — |
| PA | $1.47 | — |
| PR | $2.23 | — |
| RI | $1.47 | — |
| SC | $1.25 | — |
| SD | $1.47 | — |
| TN | $1.25 | — |
| TX | $1.34 | — |
| UT | $1.47 | — |
| VA | $1.47 | — |
| VI | $1.25 | — |
| VT | $1.47 | — |
| WA | $1.25 | — |
| WI | $1.31 | — |
| WV | $1.47 | — |
| WY | $1.47 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $9.03 to $13.57 depending on state and rural status.
Former-CBA payment limits: ceiling $10.62 · floor $9.03
| State | Non-rural | Rural |
|---|---|---|
| AK | $9.37 | — |
| AL | $10.62 | — |
| AR | $10.03 | — |
| AZ | $9.03 | — |
| CA | $9.29 | — |
| CO | $10.62 | — |
| CT | $9.03 | — |
| DC | $10.62 | — |
| DE | $10.62 | — |
| FL | $9.88 | — |
| GA | $9.03 | — |
| HI | $10.02 | — |
| IA | $9.03 | — |
| ID | $10.62 | — |
| IL | $10.62 | — |
| IN | $9.87 | — |
| KS | $9.03 | — |
| KY | $10.62 | — |
| LA | $10.34 | — |
| MA | $10.62 | — |
| MD | $10.62 | — |
| ME | $10.62 | — |
| MI | $10.62 | — |
| MN | $9.87 | — |
| MO | $9.03 | — |
| MS | $10.30 | — |
| MT | $10.62 | — |
| NC | $9.03 | — |
| ND | $10.62 | — |
| NE | $9.03 | — |
| NH | $10.62 | — |
| NJ | $10.62 | — |
| NM | $10.62 | — |
| NV | $9.03 | — |
| NY | $9.03 | — |
| OH | $10.60 | — |
| OK | $10.62 | — |
| OR | $9.03 | — |
| PA | $10.62 | — |
| PR | $13.57 | — |
| RI | $10.62 | — |
| SC | $9.03 | — |
| SD | $10.62 | — |
| TN | $9.03 | — |
| TX | $10.02 | — |
| UT | $10.62 | — |
| VA | $10.62 | — |
| VI | $9.03 | — |
| VT | $10.62 | — |
| WA | $9.03 | — |
| WI | $10.62 | — |
| WV | $10.60 | — |
| WY | $10.62 | — |
Common denial codes to watch
Related E-codes
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