MyMedi-AI

E0986 — Manual wheelchair accessory, power assist system

HCPCS Level II E-code · short descriptor: “Man w/c powr assist syst”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Capped rental
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 2026-10-26; 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 2026-10-26; 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.

E0986 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $693.24 to $831.87 depending on state and rural status.

Former-CBA payment limits: ceiling $693.24 · floor $589.25

StateNon-ruralRural
AK$693.24—
AL$693.24—
AR$693.24—
AZ$693.24—
CA$693.24—
CO$693.24—
CT$693.24—
DC$693.24—
DE$693.24—
FL$693.24—
GA$693.24—
HI$693.24—
IA$693.24—
ID$693.24—
IL$693.24—
IN$693.24—
KS$693.24—
KY$693.24—
LA$693.24—
MA$693.24—
MD$693.24—
ME$693.24—
MI$693.24—
MN$693.24—
MO$693.24—
MS$693.24—
MT$693.24—
NC$693.24—
ND$693.24—
NE$693.24—
NH$693.24—
NJ$693.24—
NM$693.24—
NV$693.24—
NY$693.24—
OH$693.24—
OK$693.24—
OR$693.24—
PA$693.24—
PR$831.87—
RI$693.24—
SC$693.24—
SD$693.24—
TN$693.24—
TX$693.24—
UT$693.24—
VA$693.24—
VI$693.24—
VT$693.24—
WA$693.24—
WI$693.24—
WV$693.24—
WY$693.24—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps E0986 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

Bill E0986 with confidence

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