E0994 — Arm rest, each
HCPCS Level II E-code · short descriptor: “Wheelchair arm rest”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Special coverage instructions apply
- 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
- 2
- 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.
E0994 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $17.41 to $47.05 depending on state and rural status.
Former-CBA payment limits: ceiling $25.13 · floor $21.36
| State | Non-rural | Rural |
|---|---|---|
| AK | $44.01 | — |
| AL | $21.36 | — |
| AR | $25.13 | — |
| AZ | $25.13 | — |
| CA | $25.13 | — |
| CO | $25.13 | — |
| CT | $25.13 | — |
| DC | $22.27 | — |
| DE | $22.59 | — |
| FL | $25.13 | — |
| GA | $21.36 | — |
| HI | $47.05 | — |
| IA | $21.36 | — |
| ID | $25.13 | — |
| IL | $25.13 | — |
| IN | $22.13 | — |
| KS | $25.13 | — |
| KY | $25.13 | — |
| LA | $23.60 | — |
| MA | $25.13 | — |
| MD | $23.45 | — |
| ME | $25.13 | — |
| MI | $25.13 | — |
| MN | $21.36 | — |
| MO | $25.13 | — |
| MS | $21.36 | — |
| MT | $25.13 | — |
| NC | $23.86 | — |
| ND | $21.92 | — |
| NE | $25.03 | — |
| NH | $25.13 | — |
| NJ | $23.96 | — |
| NM | $25.13 | — |
| NV | $25.13 | — |
| NY | $21.36 | — |
| OH | $25.13 | — |
| OK | $25.13 | — |
| OR | $23.17 | — |
| PA | $21.39 | — |
| PR | $17.41 | — |
| RI | $25.13 | — |
| SC | $25.13 | — |
| SD | $21.36 | — |
| TN | $24.69 | — |
| TX | $21.36 | — |
| UT | $25.13 | — |
| VA | $22.83 | — |
| VI | $21.36 | — |
| VT | $25.13 | — |
| WA | $25.13 | — |
| WI | $21.36 | — |
| WV | $25.00 | — |
| WY | $21.92 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $2.16 to $4.72 depending on state and rural status.
Former-CBA payment limits: ceiling $2.54 · floor $2.16
| State | Non-rural | Rural |
|---|---|---|
| AK | $4.40 | — |
| AL | $2.16 | — |
| AR | $2.54 | — |
| AZ | $2.54 | — |
| CA | $2.54 | — |
| CO | $2.54 | — |
| CT | $2.54 | — |
| DC | $2.21 | — |
| DE | $2.27 | — |
| FL | $2.54 | — |
| GA | $2.16 | — |
| HI | $4.72 | — |
| IA | $2.16 | — |
| ID | $2.54 | — |
| IL | $2.54 | — |
| IN | $2.21 | — |
| KS | $2.54 | — |
| KY | $2.54 | — |
| LA | $2.37 | — |
| MA | $2.54 | — |
| MD | $2.34 | — |
| ME | $2.54 | — |
| MI | $2.54 | — |
| MN | $2.16 | — |
| MO | $2.54 | — |
| MS | $2.16 | — |
| MT | $2.54 | — |
| NC | $2.38 | — |
| ND | $2.18 | — |
| NE | $2.50 | — |
| NH | $2.54 | — |
| NJ | $2.38 | — |
| NM | $2.54 | — |
| NV | $2.54 | — |
| NY | $2.16 | — |
| OH | $2.54 | — |
| OK | $2.54 | — |
| OR | $2.32 | — |
| PA | $2.16 | — |
| PR | $2.18 | — |
| RI | $2.54 | — |
| SC | $2.54 | — |
| SD | $2.16 | — |
| TN | $2.46 | — |
| TX | $2.16 | — |
| UT | $2.54 | — |
| VA | $2.30 | — |
| VI | $2.16 | — |
| VT | $2.54 | — |
| WA | $2.32 | — |
| WI | $2.54 | — |
| WV | $2.50 | — |
| WY | $2.18 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $13.04 to $35.29 depending on state and rural status.
Former-CBA payment limits: ceiling $18.84 · floor $16.01
| State | Non-rural | Rural |
|---|---|---|
| AK | $33.00 | — |
| AL | $16.01 | — |
| AR | $18.84 | — |
| AZ | $18.84 | — |
| CA | $18.84 | — |
| CO | $18.84 | — |
| CT | $18.84 | — |
| DC | $17.99 | — |
| DE | $16.96 | — |
| FL | $18.84 | — |
| GA | $16.01 | — |
| HI | $35.29 | — |
| IA | $16.01 | — |
| ID | $18.84 | — |
| IL | $18.84 | — |
| IN | $16.61 | — |
| KS | $18.84 | — |
| KY | $18.84 | — |
| LA | $17.72 | — |
| MA | $18.84 | — |
| MD | $17.97 | — |
| ME | $18.84 | — |
| MI | $18.84 | — |
| MN | $16.01 | — |
| MO | $18.84 | — |
| MS | $16.01 | — |
| MT | $18.84 | — |
| NC | $17.94 | — |
| ND | $16.48 | — |
| NE | $18.76 | — |
| NH | $18.84 | — |
| NJ | $17.99 | — |
| NM | $18.84 | — |
| NV | $18.84 | — |
| NY | $16.01 | — |
| OH | $18.84 | — |
| OK | $18.84 | — |
| OR | $17.38 | — |
| PA | $16.04 | — |
| PR | $13.04 | — |
| RI | $18.84 | — |
| SC | $18.84 | — |
| SD | $16.01 | — |
| TN | $18.52 | — |
| TX | $16.01 | — |
| UT | $18.84 | — |
| VA | $17.41 | — |
| VI | $16.01 | — |
| VT | $18.84 | — |
| WA | $18.84 | — |
| WI | $16.52 | — |
| WV | $18.76 | — |
| WY | $16.48 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0994 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.
Common denial codes to watch
Related E-codes
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