E0992 — Manual wheelchair accessory, solid seat insert
HCPCS Level II E-code · short descriptor: “Wheelchair solid seat insert”
- 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.
E0992 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $85.29 to $231.68 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $230.58 | — |
| AL | $100.61 | $111.45 |
| AR | $100.61 | $121.62 |
| AZ | $96.24 | $121.62 |
| CA | $100.01 | $121.62 |
| CO | $105.03 | $119.40 |
| CT | $89.98 | $121.62 |
| DC | $85.29 | $119.71 |
| DE | $85.29 | $119.71 |
| FL | $100.61 | $118.67 |
| GA | $100.61 | $111.45 |
| HI | $162.30 | — |
| IA | $102.55 | $121.62 |
| ID | $105.03 | $121.62 |
| IL | $101.47 | $121.34 |
| IN | $101.47 | $111.45 |
| KS | $102.55 | $121.62 |
| KY | $100.61 | $112.78 |
| LA | $100.61 | $121.62 |
| MA | $89.98 | $121.62 |
| MD | $85.29 | $121.62 |
| ME | $89.98 | $121.62 |
| MI | $101.47 | $111.45 |
| MN | $102.55 | $115.85 |
| MO | $102.55 | $111.45 |
| MS | $100.61 | $120.69 |
| MT | $105.03 | $111.45 |
| NC | $100.61 | $121.62 |
| ND | $102.55 | $121.62 |
| NE | $102.55 | $121.62 |
| NH | $89.98 | $121.62 |
| NJ | $85.29 | $111.45 |
| NM | $96.24 | $118.70 |
| NV | $100.01 | $121.62 |
| NY | $85.29 | $111.45 |
| OH | $101.47 | $121.62 |
| OK | $96.24 | $121.62 |
| OR | $100.01 | $121.62 |
| PA | $85.29 | $111.45 |
| PR | $231.68 | — |
| RI | $89.98 | $121.62 |
| SC | $100.61 | $112.63 |
| SD | $102.55 | $121.62 |
| TN | $100.61 | $121.05 |
| TX | $96.24 | $111.45 |
| UT | $105.03 | $121.62 |
| VA | $100.61 | $111.45 |
| VI | $114.62 | — |
| VT | $89.98 | $121.62 |
| WA | $100.01 | $121.62 |
| WI | $101.47 | $111.45 |
| WV | $100.61 | $111.45 |
| WY | $105.03 | $121.62 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $115.29 to $349.39 depending on state and rural status.
Former-CBA payment limits: ceiling $135.63 · floor $115.29
| State | Non-rural | Rural |
|---|---|---|
| AK | $347.19 | — |
| AL | $115.29 | — |
| AR | $135.63 | — |
| AZ | $135.63 | — |
| CA | $135.63 | — |
| CO | $131.15 | — |
| CT | $135.63 | — |
| DC | $131.79 | — |
| DE | $131.79 | — |
| FL | $129.70 | — |
| GA | $115.29 | — |
| HI | $210.61 | — |
| IA | $135.63 | — |
| ID | $135.63 | — |
| IL | $135.05 | — |
| IN | $115.29 | — |
| KS | $135.63 | — |
| KY | $117.93 | — |
| LA | $135.63 | — |
| MA | $135.63 | — |
| MD | $135.63 | — |
| ME | $135.63 | — |
| MI | $115.29 | — |
| MN | $124.07 | — |
| MO | $115.29 | — |
| MS | $133.75 | — |
| MT | $115.29 | — |
| NC | $135.63 | — |
| ND | $135.63 | — |
| NE | $135.63 | — |
| NH | $135.63 | — |
| NJ | $115.29 | — |
| NM | $129.78 | — |
| NV | $135.63 | — |
| NY | $115.29 | — |
| OH | $135.63 | — |
| OK | $135.63 | — |
| OR | $135.63 | — |
| PA | $115.29 | — |
| PR | $349.39 | — |
| RI | $135.63 | — |
| SC | $117.64 | — |
| SD | $135.63 | — |
| TN | $134.48 | — |
| TX | $115.29 | — |
| UT | $135.63 | — |
| VA | $115.29 | — |
| VI | $115.29 | — |
| VT | $135.63 | — |
| WA | $135.63 | — |
| WI | $115.29 | — |
| WV | $115.29 | — |
| WY | $135.63 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $8.53 to $27.52 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $23.04 | — |
| AL | $10.06 | $10.98 |
| AR | $10.06 | $11.97 |
| AZ | $9.62 | $11.97 |
| CA | $10.00 | $11.97 |
| CO | $10.50 | $11.94 |
| CT | $9.00 | $11.97 |
| DC | $8.53 | $11.97 |
| DE | $8.53 | $11.97 |
| FL | $10.06 | $11.88 |
| GA | $10.06 | $11.09 |
| HI | $16.23 | — |
| IA | $10.26 | $11.97 |
| ID | $10.50 | $11.97 |
| IL | $10.15 | $11.97 |
| IN | $10.15 | $10.98 |
| KS | $10.26 | $11.97 |
| KY | $10.06 | $11.27 |
| LA | $10.06 | $11.97 |
| MA | $9.00 | $11.03 |
| MD | $8.53 | $11.97 |
| ME | $9.00 | $11.03 |
| MI | $10.15 | $10.98 |
| MN | $10.26 | $11.58 |
| MO | $10.26 | $10.98 |
| MS | $10.06 | $11.97 |
| MT | $10.50 | $10.98 |
| NC | $10.06 | $11.97 |
| ND | $10.26 | $11.97 |
| NE | $10.26 | $11.97 |
| NH | $9.00 | $11.22 |
| NJ | $8.53 | $10.98 |
| NM | $9.62 | $11.88 |
| NV | $10.00 | $11.97 |
| NY | $8.53 | $11.13 |
| OH | $10.15 | $11.97 |
| OK | $9.62 | $11.97 |
| OR | $10.00 | $11.97 |
| PA | $8.53 | $10.98 |
| PR | $27.52 | — |
| RI | $9.00 | $10.98 |
| SC | $10.06 | $11.25 |
| SD | $10.26 | $11.97 |
| TN | $10.06 | $11.97 |
| TX | $9.62 | $10.98 |
| UT | $10.50 | $11.97 |
| VA | $10.06 | $11.08 |
| VI | $11.44 | — |
| VT | $9.00 | $11.03 |
| WA | $10.00 | $11.97 |
| WI | $10.15 | $10.98 |
| WV | $10.06 | $10.98 |
| WY | $10.50 | $11.97 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $11.19 to $43.64 depending on state and rural status.
Former-CBA payment limits: ceiling $13.17 · floor $11.19
| State | Non-rural | Rural |
|---|---|---|
| AK | $34.70 | — |
| AL | $11.19 | — |
| AR | $13.17 | — |
| AZ | $13.17 | — |
| CA | $13.17 | — |
| CO | $13.12 | — |
| CT | $13.17 | — |
| DC | $13.17 | — |
| DE | $13.17 | — |
| FL | $12.99 | — |
| GA | $11.41 | — |
| HI | $21.04 | — |
| IA | $13.17 | — |
| ID | $13.17 | — |
| IL | $13.17 | — |
| IN | $11.19 | — |
| KS | $13.17 | — |
| KY | $11.77 | — |
| LA | $13.17 | — |
| MA | $11.29 | — |
| MD | $13.17 | — |
| ME | $11.29 | — |
| MI | $11.19 | — |
| MN | $12.42 | — |
| MO | $11.19 | — |
| MS | $13.17 | — |
| MT | $11.19 | — |
| NC | $13.17 | — |
| ND | $13.17 | — |
| NE | $13.17 | — |
| NH | $11.67 | — |
| NJ | $11.19 | — |
| NM | $12.99 | — |
| NV | $13.17 | — |
| NY | $11.49 | — |
| OH | $13.17 | — |
| OK | $13.17 | — |
| OR | $13.17 | — |
| PA | $11.19 | — |
| PR | $43.64 | — |
| RI | $11.19 | — |
| SC | $11.73 | — |
| SD | $13.17 | — |
| TN | $13.17 | — |
| TX | $11.19 | — |
| UT | $13.17 | — |
| VA | $11.38 | — |
| VI | $11.49 | — |
| VT | $11.29 | — |
| WA | $13.17 | — |
| WI | $11.19 | — |
| WV | $11.19 | — |
| WY | $13.17 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $63.97 to $173.77 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $172.95 | — |
| AL | $75.46 | $83.59 |
| AR | $75.46 | $91.22 |
| AZ | $72.18 | $91.22 |
| CA | $75.01 | $91.22 |
| CO | $78.77 | $89.56 |
| CT | $67.48 | $91.22 |
| DC | $63.97 | $89.81 |
| DE | $63.97 | $89.81 |
| FL | $75.46 | $89.01 |
| GA | $75.46 | $83.59 |
| HI | $121.73 | — |
| IA | $76.91 | $91.22 |
| ID | $78.77 | $91.22 |
| IL | $76.11 | $91.01 |
| IN | $76.11 | $83.59 |
| KS | $76.91 | $91.22 |
| KY | $75.46 | $84.58 |
| LA | $75.46 | $91.22 |
| MA | $67.48 | $91.22 |
| MD | $63.97 | $91.22 |
| ME | $67.48 | $91.22 |
| MI | $76.11 | $83.59 |
| MN | $76.91 | $86.91 |
| MO | $76.91 | $83.59 |
| MS | $75.46 | $90.51 |
| MT | $78.77 | $83.59 |
| NC | $75.46 | $91.22 |
| ND | $76.91 | $91.22 |
| NE | $76.91 | $91.22 |
| NH | $67.48 | $91.22 |
| NJ | $63.97 | $83.59 |
| NM | $72.18 | $89.05 |
| NV | $75.01 | $91.22 |
| NY | $63.97 | $83.59 |
| OH | $76.11 | $91.22 |
| OK | $72.18 | $91.22 |
| OR | $75.01 | $91.22 |
| PA | $63.97 | $83.59 |
| PR | $173.77 | — |
| RI | $67.48 | $91.22 |
| SC | $75.46 | $84.49 |
| SD | $76.91 | $91.22 |
| TN | $75.46 | $90.80 |
| TX | $72.18 | $83.59 |
| UT | $78.77 | $91.22 |
| VA | $75.46 | $83.59 |
| VI | $85.97 | — |
| VT | $67.48 | $91.22 |
| WA | $75.01 | $91.22 |
| WI | $76.11 | $83.59 |
| WV | $75.46 | $83.59 |
| WY | $78.77 | $91.22 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $86.46 to $262.06 depending on state and rural status.
Former-CBA payment limits: ceiling $101.72 · floor $86.46
| State | Non-rural | Rural |
|---|---|---|
| AK | $260.42 | — |
| AL | $86.46 | — |
| AR | $101.72 | — |
| AZ | $101.72 | — |
| CA | $101.72 | — |
| CO | $98.40 | — |
| CT | $101.72 | — |
| DC | $98.90 | — |
| DE | $98.90 | — |
| FL | $97.32 | — |
| GA | $86.46 | — |
| HI | $157.99 | — |
| IA | $101.72 | — |
| ID | $101.72 | — |
| IL | $101.31 | — |
| IN | $86.46 | — |
| KS | $101.72 | — |
| KY | $88.42 | — |
| LA | $101.72 | — |
| MA | $101.72 | — |
| MD | $101.72 | — |
| ME | $101.72 | — |
| MI | $86.46 | — |
| MN | $93.11 | — |
| MO | $86.46 | — |
| MS | $100.29 | — |
| MT | $86.46 | — |
| NC | $101.72 | — |
| ND | $101.72 | — |
| NE | $101.72 | — |
| NH | $101.72 | — |
| NJ | $86.46 | — |
| NM | $97.40 | — |
| NV | $101.72 | — |
| NY | $86.46 | — |
| OH | $101.72 | — |
| OK | $101.72 | — |
| OR | $101.72 | — |
| PA | $86.46 | — |
| PR | $262.06 | — |
| RI | $101.72 | — |
| SC | $88.26 | — |
| SD | $101.72 | — |
| TN | $100.88 | — |
| TX | $86.46 | — |
| UT | $101.72 | — |
| VA | $86.46 | — |
| VI | $86.46 | — |
| VT | $101.72 | — |
| WA | $101.72 | — |
| WI | $86.46 | — |
| WV | $86.46 | — |
| WY | $101.72 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0992 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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