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E0966 — Manual wheelchair accessory, headrest extension, each

HCPCS Level II E-code · short descriptor: “Wheelchair head rest extensi”

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
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.

E0966 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $80.73 to $135.94 depending on state and rural status.

StateNon-ruralRural
AK$135.94
AL$84.94$89.80
AR$84.94$95.71
AZ$88.46$98.56
CA$83.26$98.56
CO$91.21$98.56
CT$85.67$98.56
DC$80.73$92.25
DE$80.73$92.25
FL$84.94$93.22
GA$84.94$93.43
HI$113.25
IA$91.45$98.56
ID$91.21$98.56
IL$89.77$97.65
IN$89.77$98.56
KS$91.45$98.56
KY$84.94$92.61
LA$84.94$97.17
MA$85.67$98.56
MD$80.73$86.46
ME$85.67$98.56
MI$89.77$98.56
MN$91.45$98.56
MO$91.45$98.56
MS$84.94$86.46
MT$91.21$98.56
NC$84.94$97.60
ND$91.45$92.25
NE$91.45$98.56
NH$85.67$98.56
NJ$80.73$92.25
NM$88.46$98.56
NV$83.26$98.56
NY$80.73$98.56
OH$89.77$92.29
OK$88.46$98.56
OR$83.26$98.56
PA$80.73$92.25
PR$111.65
RI$85.67$98.56
SC$84.94$93.95
SD$91.45$92.25
TN$84.94$97.92
TX$88.46$98.56
UT$91.21$96.10
VA$84.94$86.46
VI$101.12
VT$85.67$98.56
WA$83.26$98.56
WI$89.77$94.17
WV$84.94$88.27
WY$91.21$92.25

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $86.46 to $171.37 depending on state and rural status.

Former-CBA payment limits: ceiling $101.72 · floor $86.46

StateNon-ruralRural
AK$171.37
AL$89.80
AR$96.02
AZ$101.72
CA$101.72
CO$101.72
CT$101.72
DC$92.25
DE$92.25
FL$93.21
GA$93.44
HI$126.00
IA$101.72
ID$101.72
IL$99.90
IN$101.72
KS$101.72
KY$92.62
LA$98.94
MA$101.72
MD$86.46
ME$101.72
MI$101.72
MN$101.72
MO$101.72
MS$86.46
MT$101.72
NC$99.80
ND$92.25
NE$101.72
NH$101.72
NJ$92.25
NM$101.72
NV$101.72
NY$101.72
OH$92.28
OK$101.72
OR$101.72
PA$92.25
PR$122.80
RI$101.72
SC$93.95
SD$92.25
TN$100.44
TX$101.72
UT$96.80
VA$86.46
VI$101.72
VT$101.72
WA$101.72
WI$94.15
WV$88.27
WY$92.25

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $8.07 to $13.60 depending on state and rural status.

StateNon-ruralRural
AK$13.60
AL$8.49$9.79
AR$8.49$9.79
AZ$8.85$9.79
CA$8.33$9.79
CO$9.12$9.60
CT$8.57$9.79
DC$8.07$9.22
DE$8.07$9.22
FL$8.49$9.32
GA$8.49$9.33
HI$11.33
IA$9.14$9.79
ID$9.12$9.79
IL$8.98$9.79
IN$8.98$9.79
KS$9.14$9.79
KY$8.49$9.28
LA$8.49$9.71
MA$8.57$9.44
MD$8.07$9.79
ME$8.57$9.44
MI$8.98$9.79
MN$9.14$9.79
MO$9.14$9.79
MS$8.49$8.54
MT$9.12$9.79
NC$8.49$9.77
ND$9.14$9.22
NE$9.14$9.79
NH$8.57$9.44
NJ$8.07$9.22
NM$8.85$9.79
NV$8.33$9.79
NY$8.07$9.79
OH$8.98$9.24
OK$8.85$9.79
OR$8.33$9.79
PA$8.07$9.22
PR$12.72
RI$8.57$9.28
SC$8.49$9.39
SD$9.14$9.22
TN$8.49$9.79
TX$8.85$9.79
UT$9.12$9.60
VA$8.49$8.54
VI$10.04
VT$8.57$9.79
WA$8.33$9.79
WI$8.65$8.65
WV$8.49$8.85
WY$9.12$9.22

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $8.53 to $17.14 depending on state and rural status.

Former-CBA payment limits: ceiling $10.04 · floor $8.53

StateNon-ruralRural
AK$17.14
AL$10.04
AR$10.04
AZ$10.04
CA$10.04
CO$9.65
CT$10.04
DC$9.22
DE$9.22
FL$9.33
GA$9.34
HI$12.62
IA$10.04
ID$10.04
IL$10.04
IN$10.04
KS$10.04
KY$9.29
LA$9.88
MA$9.44
MD$10.04
ME$9.44
MI$10.04
MN$10.04
MO$10.04
MS$8.53
MT$10.04
NC$10.01
ND$9.22
NE$10.04
NH$9.44
NJ$9.22
NM$10.04
NV$10.04
NY$10.04
OH$9.25
OK$10.04
OR$10.04
PA$9.22
PR$15.37
RI$9.29
SC$9.39
SD$9.22
TN$10.04
TX$10.04
UT$9.65
VA$8.53
VI$10.04
VT$10.04
WA$10.04
WI$8.65
WV$8.83
WY$9.22

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $60.55 to $101.97 depending on state and rural status.

StateNon-ruralRural
AK$101.97
AL$63.71$67.39
AR$63.71$71.78
AZ$66.35$73.92
CA$62.45$73.92
CO$68.41$73.92
CT$64.26$73.92
DC$60.55$69.21
DE$60.55$69.21
FL$63.71$69.95
GA$63.71$70.10
HI$84.95
IA$68.59$73.92
ID$68.41$73.92
IL$67.33$73.25
IN$67.33$73.92
KS$68.59$73.92
KY$63.71$69.47
LA$63.71$72.87
MA$64.26$73.92
MD$60.55$64.84
ME$64.26$73.92
MI$67.33$73.92
MN$68.59$73.92
MO$68.59$73.92
MS$63.71$64.84
MT$68.41$73.92
NC$63.71$73.20
ND$68.59$69.21
NE$68.59$73.92
NH$64.26$73.92
NJ$60.55$69.21
NM$66.35$73.92
NV$62.45$73.92
NY$60.55$73.92
OH$67.33$69.23
OK$66.35$73.92
OR$62.45$73.92
PA$60.55$69.21
PR$83.75
RI$64.26$73.92
SC$63.71$70.45
SD$68.59$69.21
TN$63.71$73.44
TX$66.35$73.92
UT$68.41$72.07
VA$63.71$64.84
VI$75.84
VT$64.26$73.92
WA$62.45$73.92
WI$67.33$70.64
WV$63.71$66.20
WY$68.41$69.21

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $64.84 to $128.53 depending on state and rural status.

Former-CBA payment limits: ceiling $76.28 · floor $64.84

StateNon-ruralRural
AK$128.53
AL$67.40
AR$72.01
AZ$76.28
CA$76.28
CO$76.28
CT$76.28
DC$69.20
DE$69.20
FL$69.94
GA$70.08
HI$94.50
IA$76.28
ID$76.28
IL$74.94
IN$76.28
KS$76.28
KY$69.48
LA$74.18
MA$76.28
MD$64.84
ME$76.28
MI$76.28
MN$76.28
MO$76.28
MS$64.84
MT$76.28
NC$74.85
ND$69.20
NE$76.28
NH$76.28
NJ$69.20
NM$76.28
NV$76.28
NY$76.28
OH$69.22
OK$76.28
OR$76.28
PA$69.20
PR$92.10
RI$76.28
SC$70.44
SD$69.20
TN$75.35
TX$76.28
UT$72.58
VA$64.84
VI$76.28
VT$76.28
WA$76.28
WI$70.64
WV$66.20
WY$69.20
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.

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