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
- 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 2026-10-26; 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 2026-10-26; 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.
E0955 Medicare fee schedule (October 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $17.12 to $24.66 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0955 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
Bill E0955 with confidence
Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →
Building an AI agent? Try the agent API in the playground — free PA-required lookups, E0955 included, and starter credits via POST /bot-marketplace/register.