E0958 — Manual wheelchair accessory, one-arm drive attachment, each

HCPCS Level II E-code · short descriptor: “Whlchr att- conv 1 arm drive”

Code system: HCPCS Level II
Family: E — Durable medical equipment
Medicare coverage status: Special coverage instructions apply
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.

E0958 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $48.32 to $69.13 depending on state and rural status.

State	Non-rural	Rural
AK	$58.01	—
AL	$50.53	$54.67
AR	$50.53	$59.02
AZ	$50.79	$59.02
CA	$48.32	$56.67
CO	$50.44	$59.02
CT	$49.25	$59.02
DC	$49.72	$59.02
DE	$49.72	$59.02
FL	$50.53	$55.18
GA	$50.53	$58.49
HI	$61.82	—
IA	$54.40	$59.02
ID	$50.44	$59.02
IL	$51.87	$59.02
IN	$51.87	$59.02
KS	$54.40	$59.02
KY	$50.53	$59.02
LA	$50.53	$59.02
MA	$49.25	$52.85
MD	$49.72	$52.85
ME	$49.25	$53.31
MI	$51.87	$57.60
MN	$54.40	$56.76
MO	$54.40	$59.02
MS	$50.53	$56.03
MT	$50.44	$59.02
NC	$50.53	$59.02
ND	$54.40	$55.98
NE	$54.40	$59.02
NH	$49.25	$52.85
NJ	$49.72	$58.16
NM	$50.79	$56.12
NV	$48.32	$59.02
NY	$49.72	$58.82
OH	$51.87	$59.02
OK	$50.79	$59.02
OR	$48.32	$59.02
PA	$49.72	$58.85
PR	$69.13	—
RI	$49.25	$52.85
SC	$50.53	$59.02
SD	$54.40	$56.40
TN	$50.53	$55.78
TX	$50.79	$56.36
UT	$50.44	$59.02
VA	$50.53	$52.85
VI	$61.68	—
VT	$49.25	$52.85
WA	$48.32	$59.02
WI	$51.87	$52.85
WV	$50.53	$59.02
WY	$50.44	$58.40

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $52.84 to $76.67 depending on state and rural status.

Former-CBA payment limits: ceiling $62.17 · floor $52.84

State	Non-rural	Rural
AK	$58.01	—
AL	$54.68	—
AR	$62.17	—
AZ	$62.17	—
CA	$57.44	—
CO	$62.17	—
CT	$62.17	—
DC	$62.17	—
DE	$62.17	—
FL	$55.18	—
GA	$61.10	—
HI	$62.05	—
IA	$62.17	—
ID	$62.17	—
IL	$62.17	—
IN	$62.17	—
KS	$62.17	—
KY	$62.17	—
LA	$62.17	—
MA	$52.84	—
MD	$52.84	—
ME	$53.31	—
MI	$59.33	—
MN	$57.63	—
MO	$62.17	—
MS	$56.18	—
MT	$62.17	—
NC	$62.17	—
ND	$56.10	—
NE	$62.17	—
NH	$52.84	—
NJ	$60.47	—
NM	$56.37	—
NV	$62.17	—
NY	$61.77	—
OH	$62.17	—
OK	$62.17	—
OR	$62.17	—
PA	$61.84	—
PR	$76.67	—
RI	$52.84	—
SC	$62.17	—
SD	$56.91	—
TN	$55.77	—
TX	$56.85	—
UT	$62.17	—
VA	$52.84	—
VI	$61.77	—
VT	$52.84	—
WA	$62.17	—
WI	$52.84	—
WV	$62.17	—
WY	$60.93	—

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

CO-50 medical necessity

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