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E0955 — Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each

HCPCS Level II E-code · short descriptor: “Cushioned headrest”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Capped rental
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.

E0955 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $17.12 to $24.66 depending on state and rural status.

StateNon-ruralRural
AK$22.18
AL$17.71$22.18
AR$17.71$22.18
AZ$17.51$22.18
CA$17.12$22.18
CO$17.80$22.18
CT$18.07$22.18
DC$17.35$22.18
DE$17.35$22.18
FL$17.71$22.18
GA$17.71$22.18
HI$22.18
IA$17.92$22.18
ID$17.80$22.18
IL$18.20$22.18
IN$18.20$22.18
KS$17.92$22.18
KY$17.71$22.18
LA$17.71$22.18
MA$18.07$22.18
MD$17.35$22.18
ME$18.07$22.18
MI$18.20$22.18
MN$17.92$22.18
MO$17.92$22.18
MS$17.71$22.18
MT$17.80$22.18
NC$17.71$22.18
ND$17.92$22.18
NE$17.92$22.18
NH$18.07$22.18
NJ$17.35$22.18
NM$17.51$22.18
NV$17.12$22.18
NY$17.35$22.18
OH$18.20$22.18
OK$17.51$22.18
OR$17.12$22.18
PA$17.35$22.18
PR$24.66
RI$18.07$22.18
SC$17.71$22.18
SD$17.92$22.18
TN$17.71$22.18
TX$17.51$22.18
UT$17.80$22.18
VA$17.71$22.18
VI$22.18
VT$18.07$22.18
WA$17.12$22.18
WI$18.20$22.18
WV$17.71$22.18
WY$17.80$22.18

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $23.98 to $26.82 depending on state and rural status.

StateNon-ruralRural
AK$23.98
AL$23.98
AR$23.98
AZ$23.98
CA$23.98
CO$23.98
CT$23.98
DC$23.98
DE$23.98
FL$23.98
GA$23.98
HI$23.98
IA$23.98
ID$23.98
IL$23.98
IN$23.98
KS$23.98
KY$23.98
LA$23.98
MA$23.98
MD$23.98
ME$23.98
MI$23.98
MN$23.98
MO$23.98
MS$23.98
MT$23.98
NC$23.98
ND$23.98
NE$23.98
NH$23.98
NJ$23.98
NM$23.98
NV$23.98
NY$23.98
OH$23.98
OK$23.98
OR$23.98
PA$23.98
PR$26.82
RI$23.98
SC$23.98
SD$23.98
TN$23.98
TX$23.98
UT$23.98
VA$23.98
VI$23.98
VT$23.98
WA$23.98
WI$23.98
WV$23.98
WY$23.98

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $24.83 to $29.82 depending on state and rural status.

Former-CBA payment limits: ceiling $24.83 · floor $21.11

StateNon-ruralRural
AK$24.83
AL$24.83
AR$24.83
AZ$24.83
CA$24.83
CO$24.83
CT$24.83
DC$24.83
DE$24.83
FL$24.83
GA$24.83
HI$24.83
IA$24.83
ID$24.83
IL$24.83
IN$24.83
KS$24.83
KY$24.83
LA$24.83
MA$24.83
MD$24.83
ME$24.83
MI$24.83
MN$24.83
MO$24.83
MS$24.83
MT$24.83
NC$24.83
ND$24.83
NE$24.83
NH$24.83
NJ$24.83
NM$24.83
NV$24.83
NY$24.83
OH$24.83
OK$24.83
OR$24.83
PA$24.83
PR$29.82
RI$24.83
SC$24.83
SD$24.83
TN$24.83
TX$24.83
UT$24.83
VA$24.83
VI$24.83
VT$24.83
WA$24.83
WI$24.83
WV$24.83
WY$24.83
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.

Common denial codes to watch

Related E-codes

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