E0950 — Wheelchair accessory, tray, each
HCPCS Level II E-code · short descriptor: “Tray”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Inexpensive or routinely purchased
- Prior authorization
- Not on Medicare required-PA list
- Face-to-face & WOPD
- Not on the required list
- MUE unit limit
- 1
- 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.
E0950 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $88.34 to $164.14 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $164.14 | — |
| AL | $94.50 | $115.07 |
| AR | $94.50 | $105.49 |
| AZ | $92.99 | $106.21 |
| CA | $89.53 | $108.36 |
| CO | $97.21 | $115.07 |
| CT | $88.77 | $115.07 |
| DC | $88.34 | $115.07 |
| DE | $88.34 | $115.07 |
| FL | $94.50 | $105.49 |
| GA | $94.50 | $105.49 |
| HI | $120.63 | — |
| IA | $96.42 | $105.49 |
| ID | $97.21 | $115.07 |
| IL | $95.18 | $115.07 |
| IN | $95.18 | $115.07 |
| KS | $96.42 | $105.49 |
| KY | $94.50 | $115.07 |
| LA | $94.50 | $105.49 |
| MA | $88.77 | $105.49 |
| MD | $88.34 | $115.07 |
| ME | $88.77 | $105.49 |
| MI | $95.18 | $115.07 |
| MN | $96.42 | $105.60 |
| MO | $96.42 | $105.49 |
| MS | $94.50 | $115.07 |
| MT | $97.21 | $112.29 |
| NC | $94.50 | $115.07 |
| ND | $96.42 | $115.07 |
| NE | $96.42 | $105.49 |
| NH | $88.77 | $105.49 |
| NJ | $88.34 | $115.07 |
| NM | $92.99 | $115.07 |
| NV | $89.53 | $107.08 |
| NY | $88.34 | $105.49 |
| OH | $95.18 | $105.49 |
| OK | $92.99 | $115.07 |
| OR | $89.53 | $115.07 |
| PA | $88.34 | $115.07 |
| PR | $121.35 | — |
| RI | $88.77 | $105.49 |
| SC | $94.50 | $105.49 |
| SD | $96.42 | $115.07 |
| TN | $94.50 | $115.07 |
| TX | $92.99 | $115.07 |
| UT | $97.21 | $105.49 |
| VA | $94.50 | $115.07 |
| VI | $105.49 | — |
| VT | $88.77 | $105.49 |
| WA | $89.53 | $115.07 |
| WI | $95.18 | $115.07 |
| WV | $94.50 | $105.49 |
| WY | $97.21 | $115.07 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $113.36 to $180.51 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $180.51 | — |
| AL | — | $124.33 |
| AR | — | $113.36 |
| AZ | — | $114.18 |
| CA | — | $116.64 |
| CO | — | $124.33 |
| CT | — | $124.33 |
| DC | — | $124.33 |
| DE | — | $124.33 |
| FL | — | $113.36 |
| GA | — | $113.36 |
| HI | $130.69 | — |
| IA | — | $113.36 |
| ID | — | $124.33 |
| IL | — | $124.33 |
| IN | — | $124.33 |
| KS | — | $113.36 |
| KY | — | $124.33 |
| LA | — | $113.36 |
| MA | — | $113.36 |
| MD | — | $124.33 |
| ME | — | $113.36 |
| MI | — | $124.33 |
| MN | — | $113.48 |
| MO | — | $113.36 |
| MS | — | $124.33 |
| MT | — | $121.14 |
| NC | — | $124.33 |
| ND | — | $124.33 |
| NE | — | $113.36 |
| NH | — | $113.36 |
| NJ | — | $124.33 |
| NM | — | $124.33 |
| NV | — | $115.18 |
| NY | — | $113.36 |
| OH | — | $113.36 |
| OK | — | $124.33 |
| OR | — | $124.33 |
| PA | — | $124.33 |
| PR | $131.52 | — |
| RI | — | $113.36 |
| SC | — | $113.36 |
| SD | — | $124.33 |
| TN | — | $124.33 |
| TX | — | $124.33 |
| UT | — | $113.36 |
| VA | — | $124.33 |
| VI | $113.36 | — |
| VT | — | $113.36 |
| WA | — | $124.33 |
| WI | — | $124.33 |
| WV | — | $113.36 |
| WY | — | $124.33 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $108.54 to $225.84 depending on state and rural status.
Former-CBA payment limits: ceiling $127.69 · floor $108.54
| State | Non-rural | Rural |
|---|---|---|
| AK | $225.84 | — |
| AL | $127.69 | — |
| AR | $108.54 | — |
| AZ | $109.99 | — |
| CA | $114.27 | — |
| CO | $127.69 | — |
| CT | $127.69 | — |
| DC | $127.69 | — |
| DE | $127.69 | — |
| FL | $108.54 | — |
| GA | $108.54 | — |
| HI | $138.81 | — |
| IA | $108.54 | — |
| ID | $127.69 | — |
| IL | $127.69 | — |
| IN | $127.69 | — |
| KS | $108.54 | — |
| KY | $127.69 | — |
| LA | $108.54 | — |
| MA | $108.54 | — |
| MD | $127.69 | — |
| ME | $108.54 | — |
| MI | $127.69 | — |
| MN | $108.75 | — |
| MO | $108.54 | — |
| MS | $127.69 | — |
| MT | $122.13 | — |
| NC | $127.69 | — |
| ND | $127.69 | — |
| NE | $108.54 | — |
| NH | $108.54 | — |
| NJ | $127.69 | — |
| NM | $127.69 | — |
| NV | $111.71 | — |
| NY | $108.54 | — |
| OH | $108.54 | — |
| OK | $127.69 | — |
| OR | $127.69 | — |
| PA | $127.69 | — |
| PR | $140.26 | — |
| RI | $108.54 | — |
| SC | $108.54 | — |
| SD | $127.69 | — |
| TN | $127.69 | — |
| TX | $127.69 | — |
| UT | $108.54 | — |
| VA | $127.69 | — |
| VI | $108.54 | — |
| VT | $108.54 | — |
| WA | $127.69 | — |
| WI | $127.69 | — |
| WV | $108.54 | — |
| WY | $127.69 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $8.83 to $16.41 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $16.41 | — |
| AL | $9.45 | $11.52 |
| AR | $9.45 | $10.56 |
| AZ | $9.30 | $11.52 |
| CA | $8.95 | $10.83 |
| CO | $9.72 | $11.52 |
| CT | $8.88 | $11.52 |
| DC | $8.83 | $11.52 |
| DE | $8.83 | $11.52 |
| FL | $9.45 | $10.56 |
| GA | $9.45 | $10.56 |
| HI | $12.07 | — |
| IA | $9.64 | $10.56 |
| ID | $9.72 | $11.52 |
| IL | $9.52 | $11.52 |
| IN | $9.52 | $11.52 |
| KS | $9.64 | $10.56 |
| KY | $9.45 | $11.52 |
| LA | $9.45 | $10.56 |
| MA | $8.88 | $10.56 |
| MD | $8.83 | $11.52 |
| ME | $8.88 | $10.56 |
| MI | $9.52 | $11.52 |
| MN | $9.64 | $10.56 |
| MO | $9.64 | $10.56 |
| MS | $9.45 | $11.52 |
| MT | $9.72 | $11.22 |
| NC | $9.45 | $11.52 |
| ND | $9.64 | $11.52 |
| NE | $9.64 | $10.56 |
| NH | $8.88 | $10.56 |
| NJ | $8.83 | $11.52 |
| NM | $9.30 | $11.52 |
| NV | $8.95 | $11.52 |
| NY | $8.83 | $10.56 |
| OH | $9.52 | $10.56 |
| OK | $9.30 | $11.52 |
| OR | $8.95 | $11.52 |
| PA | $8.83 | $11.52 |
| PR | $13.89 | — |
| RI | $8.88 | $10.56 |
| SC | $9.45 | $10.56 |
| SD | $9.64 | $11.52 |
| TN | $9.45 | $11.52 |
| TX | $9.30 | $11.52 |
| UT | $9.72 | $10.56 |
| VA | $9.45 | $11.52 |
| VI | $10.56 | — |
| VT | $8.88 | $10.56 |
| WA | $8.95 | $11.52 |
| WI | $9.52 | $11.52 |
| WV | $9.45 | $10.56 |
| WY | $9.72 | $11.52 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $11.35 to $18.05 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $18.05 | — |
| AL | — | $12.45 |
| AR | — | $11.35 |
| AZ | — | $12.45 |
| CA | — | $11.66 |
| CO | — | $12.45 |
| CT | — | $12.45 |
| DC | — | $12.45 |
| DE | — | $12.45 |
| FL | — | $11.35 |
| GA | — | $11.35 |
| HI | $13.08 | — |
| IA | — | $11.35 |
| ID | — | $12.45 |
| IL | — | $12.45 |
| IN | — | $12.45 |
| KS | — | $11.35 |
| KY | — | $12.45 |
| LA | — | $11.35 |
| MA | — | $11.35 |
| MD | — | $12.45 |
| ME | — | $11.35 |
| MI | — | $12.45 |
| MN | — | $11.35 |
| MO | — | $11.35 |
| MS | — | $12.45 |
| MT | — | $12.11 |
| NC | — | $12.45 |
| ND | — | $12.45 |
| NE | — | $11.35 |
| NH | — | $11.35 |
| NJ | — | $12.45 |
| NM | — | $12.45 |
| NV | — | $12.45 |
| NY | — | $11.35 |
| OH | — | $11.35 |
| OK | — | $12.45 |
| OR | — | $12.45 |
| PA | — | $12.45 |
| PR | $15.16 | — |
| RI | — | $11.35 |
| SC | — | $11.35 |
| SD | — | $12.45 |
| TN | — | $12.45 |
| TX | — | $12.45 |
| UT | — | $11.35 |
| VA | — | $12.45 |
| VI | $11.35 | — |
| VT | — | $11.35 |
| WA | — | $12.45 |
| WI | — | $12.45 |
| WV | — | $11.35 |
| WY | — | $12.45 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $10.87 to $22.57 depending on state and rural status.
Former-CBA payment limits: ceiling $12.79 · floor $10.87
| State | Non-rural | Rural |
|---|---|---|
| AK | $22.57 | — |
| AL | $12.79 | — |
| AR | $10.87 | — |
| AZ | $12.79 | — |
| CA | $11.41 | — |
| CO | $12.79 | — |
| CT | $12.79 | — |
| DC | $12.79 | — |
| DE | $12.79 | — |
| FL | $10.87 | — |
| GA | $10.87 | — |
| HI | $13.90 | — |
| IA | $10.87 | — |
| ID | $12.79 | — |
| IL | $12.79 | — |
| IN | $12.79 | — |
| KS | $10.87 | — |
| KY | $12.79 | — |
| LA | $10.87 | — |
| MA | $10.87 | — |
| MD | $12.79 | — |
| ME | $10.87 | — |
| MI | $12.79 | — |
| MN | $10.87 | — |
| MO | $10.87 | — |
| MS | $12.79 | — |
| MT | $12.20 | — |
| NC | $12.79 | — |
| ND | $12.79 | — |
| NE | $10.87 | — |
| NH | $10.87 | — |
| NJ | $12.79 | — |
| NM | $12.79 | — |
| NV | $12.79 | — |
| NY | $10.87 | — |
| OH | $10.87 | — |
| OK | $12.79 | — |
| OR | $12.79 | — |
| PA | $12.79 | — |
| PR | $17.55 | — |
| RI | $10.87 | — |
| SC | $10.87 | — |
| SD | $12.79 | — |
| TN | $12.79 | — |
| TX | $12.79 | — |
| UT | $10.87 | — |
| VA | $12.79 | — |
| VI | $10.87 | — |
| VT | $10.87 | — |
| WA | $12.79 | — |
| WI | $12.79 | — |
| WV | $10.87 | — |
| WY | $12.79 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $66.25 to $123.11 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $123.11 | — |
| AL | $70.88 | $86.30 |
| AR | $70.88 | $79.12 |
| AZ | $69.74 | $79.12 |
| CA | $67.15 | $81.27 |
| CO | $72.91 | $86.30 |
| CT | $66.58 | $86.30 |
| DC | $66.25 | $86.30 |
| DE | $66.25 | $86.30 |
| FL | $70.88 | $79.12 |
| GA | $70.88 | $79.12 |
| HI | $90.46 | — |
| IA | $72.32 | $79.12 |
| ID | $72.91 | $86.30 |
| IL | $71.39 | $86.30 |
| IN | $71.39 | $86.30 |
| KS | $72.32 | $79.12 |
| KY | $70.88 | $86.30 |
| LA | $70.88 | $79.12 |
| MA | $66.58 | $79.12 |
| MD | $66.25 | $86.30 |
| ME | $66.58 | $79.12 |
| MI | $71.39 | $86.30 |
| MN | $72.32 | $79.20 |
| MO | $72.32 | $79.12 |
| MS | $70.88 | $86.30 |
| MT | $72.91 | $84.20 |
| NC | $70.88 | $86.30 |
| ND | $72.32 | $86.30 |
| NE | $72.32 | $79.12 |
| NH | $66.58 | $79.12 |
| NJ | $66.25 | $86.30 |
| NM | $69.74 | $86.30 |
| NV | $67.15 | $79.12 |
| NY | $66.25 | $79.12 |
| OH | $71.39 | $79.12 |
| OK | $69.74 | $86.30 |
| OR | $67.15 | $86.30 |
| PA | $66.25 | $86.30 |
| PR | $91.00 | — |
| RI | $66.58 | $79.12 |
| SC | $70.88 | $79.12 |
| SD | $72.32 | $86.30 |
| TN | $70.88 | $86.30 |
| TX | $69.74 | $86.30 |
| UT | $72.91 | $79.12 |
| VA | $70.88 | $86.30 |
| VI | $79.12 | — |
| VT | $66.58 | $79.12 |
| WA | $67.15 | $86.30 |
| WI | $71.39 | $86.30 |
| WV | $70.88 | $79.12 |
| WY | $72.91 | $86.30 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $85.02 to $135.39 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $135.39 | — |
| AL | — | $93.25 |
| AR | — | $85.02 |
| AZ | — | $85.02 |
| CA | — | $87.48 |
| CO | — | $93.25 |
| CT | — | $93.25 |
| DC | — | $93.25 |
| DE | — | $93.25 |
| FL | — | $85.02 |
| GA | — | $85.02 |
| HI | $98.01 | — |
| IA | — | $85.02 |
| ID | — | $93.25 |
| IL | — | $93.25 |
| IN | — | $93.25 |
| KS | — | $85.02 |
| KY | — | $93.25 |
| LA | — | $85.02 |
| MA | — | $85.02 |
| MD | — | $93.25 |
| ME | — | $85.02 |
| MI | — | $93.25 |
| MN | — | $85.11 |
| MO | — | $85.02 |
| MS | — | $93.25 |
| MT | — | $90.84 |
| NC | — | $93.25 |
| ND | — | $93.25 |
| NE | — | $85.02 |
| NH | — | $85.02 |
| NJ | — | $93.25 |
| NM | — | $93.25 |
| NV | — | $85.02 |
| NY | — | $85.02 |
| OH | — | $85.02 |
| OK | — | $93.25 |
| OR | — | $93.25 |
| PA | — | $93.25 |
| PR | $98.63 | — |
| RI | — | $85.02 |
| SC | — | $85.02 |
| SD | — | $93.25 |
| TN | — | $93.25 |
| TX | — | $93.25 |
| UT | — | $85.02 |
| VA | — | $93.25 |
| VI | $85.02 | — |
| VT | — | $85.02 |
| WA | — | $93.25 |
| WI | — | $93.25 |
| WV | — | $85.02 |
| WY | — | $93.25 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $81.40 to $169.39 depending on state and rural status.
Former-CBA payment limits: ceiling $95.77 · floor $81.40
| State | Non-rural | Rural |
|---|---|---|
| AK | $169.39 | — |
| AL | $95.77 | — |
| AR | $81.40 | — |
| AZ | $81.40 | — |
| CA | $85.71 | — |
| CO | $95.77 | — |
| CT | $95.77 | — |
| DC | $95.77 | — |
| DE | $95.77 | — |
| FL | $81.40 | — |
| GA | $81.40 | — |
| HI | $104.11 | — |
| IA | $81.40 | — |
| ID | $95.77 | — |
| IL | $95.77 | — |
| IN | $95.77 | — |
| KS | $81.40 | — |
| KY | $95.77 | — |
| LA | $81.40 | — |
| MA | $81.40 | — |
| MD | $95.77 | — |
| ME | $81.40 | — |
| MI | $95.77 | — |
| MN | $81.55 | — |
| MO | $81.40 | — |
| MS | $95.77 | — |
| MT | $91.57 | — |
| NC | $95.77 | — |
| ND | $95.77 | — |
| NE | $81.40 | — |
| NH | $81.40 | — |
| NJ | $95.77 | — |
| NM | $95.77 | — |
| NV | $81.40 | — |
| NY | $81.40 | — |
| OH | $81.40 | — |
| OK | $95.77 | — |
| OR | $95.77 | — |
| PA | $95.77 | — |
| PR | $105.15 | — |
| RI | $81.40 | — |
| SC | $81.40 | — |
| SD | $95.77 | — |
| TN | $95.77 | — |
| TX | $95.77 | — |
| UT | $81.40 | — |
| VA | $95.77 | — |
| VI | $81.40 | — |
| VT | $81.40 | — |
| WA | $95.77 | — |
| WI | $95.77 | — |
| WV | $81.40 | — |
| WY | $95.77 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0950 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.
Common denial codes to watch
Related E-codes
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