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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
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

E0950 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $88.34 to $164.14 depending on state and rural status.

StateNon-ruralRural
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.

StateNon-ruralRural
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

StateNon-ruralRural
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.

StateNon-ruralRural
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.

StateNon-ruralRural
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

StateNon-ruralRural
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.

StateNon-ruralRural
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.

StateNon-ruralRural
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

StateNon-ruralRural
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
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

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