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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Common denial codes to watch
Related E-codes
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