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
- 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 2026-10-25; 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 2026-10-25; 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.
E0966 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $80.73 to $135.94 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0966 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
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