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E0961 — Manual wheelchair accessory, wheel lock brake extension (handle), each

HCPCS Level II E-code · short descriptor: “Wheelchair brake extension”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Inexpensive or routinely purchased
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required 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.

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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

E0961 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $14.14 to $34.97 depending on state and rural status.

StateNon-ruralRural
AK$22.29
AL$24.62$31.79
AR$24.62$34.97
AZ$24.17$34.97
CA$26.67$34.97
CO$25.10$34.97
CT$26.21$34.97
DC$23.86$34.49
DE$23.86$34.49
FL$24.62$31.79
GA$24.62$31.79
HI$28.99
IA$25.32$34.97
ID$25.10$31.79
IL$24.97$34.97
IN$24.97$31.79
KS$25.32$34.97
KY$24.62$31.79
LA$24.62$34.97
MA$26.21$34.97
MD$23.86$34.49
ME$26.21$34.97
MI$24.97$32.97
MN$25.32$34.97
MO$25.32$32.59
MS$24.62$31.79
MT$25.10$34.97
NC$24.62$31.79
ND$25.32$34.97
NE$25.32$34.97
NH$26.21$34.97
NJ$23.86$31.79
NM$24.17$31.79
NV$26.67$34.97
NY$23.86$31.79
OH$24.97$31.79
OK$24.17$34.97
OR$26.67$32.32
PA$23.86$32.05
PR$14.14
RI$26.21$34.97
SC$24.62$34.97
SD$25.32$34.97
TN$24.62$31.79
TX$24.17$33.86
UT$25.10$34.97
VA$24.62$31.79
VI$31.79
VT$26.21$34.97
WA$26.67$31.79
WI$24.97$31.79
WV$24.62$34.97
WY$25.10$34.97

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $14.14 to $42.40 depending on state and rural status.

Former-CBA payment limits: ceiling $42.40 · floor $36.04

StateNon-ruralRural
AK$22.28
AL$36.04
AR$42.40
AZ$42.40
CA$42.40
CO$42.40
CT$42.40
DC$41.46
DE$41.46
FL$36.04
GA$36.04
HI$30.44
IA$42.40
ID$36.04
IL$42.40
IN$36.04
KS$42.40
KY$36.04
LA$42.40
MA$42.40
MD$41.46
ME$42.40
MI$38.40
MN$42.40
MO$37.61
MS$36.04
MT$42.40
NC$36.04
ND$42.40
NE$42.40
NH$42.40
NJ$36.04
NM$36.04
NV$42.40
NY$36.04
OH$36.04
OK$42.40
OR$37.08
PA$36.56
PR$14.14
RI$42.40
SC$42.40
SD$42.40
TN$36.04
TX$40.17
UT$42.40
VA$36.04
VI$36.04
VT$42.40
WA$36.04
WI$36.04
WV$42.40
WY$42.40

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $1.76 to $3.59 depending on state and rural status.

StateNon-ruralRural
AK$2.25
AL$2.46$3.59
AR$2.46$3.59
AZ$2.42$3.59
CA$2.67$3.59
CO$2.51$3.57
CT$2.62$3.59
DC$2.39$3.44
DE$2.39$3.44
FL$2.46$3.26
GA$2.46$3.26
HI$2.90
IA$2.53$3.59
ID$2.51$3.26
IL$2.50$3.59
IN$2.50$3.26
KS$2.53$3.59
KY$2.46$3.26
LA$2.46$3.59
MA$2.62$3.26
MD$2.39$3.59
ME$2.62$3.26
MI$2.50$3.31
MN$2.53$3.59
MO$2.53$3.59
MS$2.46$3.26
MT$2.51$3.51
NC$2.46$3.26
ND$2.53$3.59
NE$2.53$3.59
NH$2.62$3.26
NJ$2.39$3.26
NM$2.42$3.26
NV$2.67$3.59
NY$2.39$3.26
OH$2.50$3.26
OK$2.42$3.59
OR$2.67$3.26
PA$2.39$3.59
PR$1.76
RI$2.62$3.26
SC$2.46$3.59
SD$2.53$3.59
TN$2.46$3.26
TX$2.42$3.59
UT$2.51$3.59
VA$2.46$3.26
VI$3.26
VT$2.62$3.59
WA$2.67$3.59
WI$2.50$3.26
WV$2.46$3.59
WY$2.51$3.59

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $1.74 to $4.43 depending on state and rural status.

Former-CBA payment limits: ceiling $4.43 · floor $3.77

StateNon-ruralRural
AK$2.23
AL$4.43
AR$4.43
AZ$4.43
CA$4.43
CO$4.39
CT$4.43
DC$4.15
DE$4.15
FL$3.77
GA$3.77
HI$3.07
IA$4.43
ID$3.77
IL$4.43
IN$3.77
KS$4.43
KY$3.77
LA$4.43
MA$3.77
MD$4.43
ME$3.77
MI$3.87
MN$4.43
MO$4.43
MS$3.77
MT$4.28
NC$3.77
ND$4.43
NE$4.43
NH$3.77
NJ$3.77
NM$3.77
NV$4.43
NY$3.77
OH$3.77
OK$4.43
OR$3.77
PA$4.43
PR$1.74
RI$3.77
SC$4.43
SD$4.43
TN$3.77
TX$4.43
UT$4.43
VA$3.77
VI$3.77
VT$4.43
WA$4.43
WI$3.77
WV$4.43
WY$4.43

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $10.57 to $21.72 depending on state and rural status.

StateNon-ruralRural
AK$16.76
AL$17.99$17.99
AR$18.47$20.91
AZ$18.12$20.91
CA$20.01$20.91
CO$18.83$20.91
CT$18.35$18.35
DC$17.89$17.99
DE$17.89$17.99
FL$18.47$20.91
GA$18.47$20.91
HI$21.72
IA$18.99$20.91
ID$18.53$18.53
IL$18.73$18.76
IN$17.99$17.99
KS$18.99$20.91
KY$18.47$20.91
LA$18.47$20.91
MA$17.99$17.99
MD$17.89$17.99
ME$17.99$17.99
MI$17.99$17.99
MN$18.99$19.13
MO$18.99$20.91
MS$17.99$17.99
MT$18.83$20.91
NC$18.03$18.03
ND$18.99$20.91
NE$18.99$20.91
NH$19.66$20.91
NJ$17.89$17.99
NM$18.12$18.62
NV$20.01$20.91
NY$17.89$17.99
OH$17.99$17.99
OK$18.12$20.91
OR$20.01$20.91
PA$17.89$17.99
PR$10.57
RI$19.09$19.09
SC$18.47$20.91
SD$18.99$20.91
TN$17.99$17.99
TX$18.12$20.91
UT$18.83$20.91
VA$17.99$17.99
VI$17.99
VT$19.66$20.91
WA$20.01$20.91
WI$17.99$17.99
WV$17.99$17.99
WY$18.83$20.91

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $10.58 to $22.79 depending on state and rural status.

Former-CBA payment limits: ceiling $21.13 · floor $17.96

StateNon-ruralRural
AK$16.75
AL$17.96
AR$21.13
AZ$21.13
CA$21.13
CO$21.13
CT$18.33
DC$17.96
DE$17.96
FL$21.13
GA$21.13
HI$22.79
IA$21.13
ID$18.52
IL$18.76
IN$17.96
KS$21.13
KY$21.13
LA$21.13
MA$17.96
MD$17.96
ME$17.96
MI$17.96
MN$19.13
MO$21.13
MS$17.96
MT$21.13
NC$18.02
ND$21.13
NE$21.13
NH$21.13
NJ$17.96
NM$18.63
NV$21.13
NY$17.96
OH$17.96
OK$21.13
OR$21.13
PA$17.96
PR$10.58
RI$19.09
SC$21.13
SD$21.13
TN$17.96
TX$21.13
UT$21.13
VA$17.96
VI$17.96
VT$21.13
WA$21.13
WI$17.96
WV$17.96
WY$21.13
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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