MyMedi-AI

E1003 — Wheelchair accessory, power seating system, recline only, without shear reduction

HCPCS Level II E-code · short descriptor: “Pwr seat recline”

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 2026-10-25; 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.

E1003 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $539.40 to $594.85 depending on state and rural status.

StateNon-ruralRural
AK$539.40—
AL$539.40$539.40
AR$539.40$539.40
AZ$539.40$539.40
CA$539.40$539.40
CO$539.40$539.40
CT$539.40$539.40
DC$539.40$539.40
DE$539.40$539.40
FL$539.40$539.40
GA$539.40$539.40
HI$539.40—
IA$539.40$539.40
ID$539.40$539.40
IL$539.40$539.40
IN$539.40$539.40
KS$539.40$539.40
KY$539.40$539.40
LA$539.40$539.40
MA$539.40$539.40
MD$539.40$539.40
ME$539.40$539.40
MI$539.40$539.40
MN$539.40$539.40
MO$539.40$539.40
MS$539.40$539.40
MT$539.40$539.40
NC$539.40$539.40
ND$539.40$539.40
NE$539.40$539.40
NH$539.40$539.40
NJ$539.40$539.40
NM$539.40$539.40
NV$539.40$539.40
NY$539.40$539.40
OH$539.40$539.40
OK$539.40$539.40
OR$539.40$539.40
PA$539.40$539.40
PR$594.85—
RI$539.40$539.40
SC$539.40$539.40
SD$539.40$539.40
TN$539.40$539.40
TX$539.40$539.40
UT$539.40$539.40
VA$539.40$539.40
VI$539.40—
VT$539.40$539.40
WA$539.40$539.40
WI$539.40$539.40
WV$539.40$539.40
WY$539.40$539.40

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $580.03 to $641.78 depending on state and rural status.

StateNon-ruralRural
AK$580.03—
AL—$580.03
AR—$580.03
AZ—$580.03
CA—$580.03
CO—$580.03
CT—$580.03
DC—$580.03
DE—$580.03
FL—$580.03
GA—$580.03
HI$580.03—
IA—$580.03
ID—$580.03
IL—$580.03
IN—$580.03
KS—$580.03
KY—$580.03
LA—$580.03
MA—$580.03
MD—$580.03
ME—$580.03
MI—$580.03
MN—$580.03
MO—$580.03
MS—$580.03
MT—$580.03
NC—$580.03
ND—$580.03
NE—$580.03
NH—$580.03
NJ—$580.03
NM—$580.03
NV—$580.03
NY—$580.03
OH—$580.03
OK—$580.03
OR—$580.03
PA—$580.03
PR$641.78—
RI—$580.03
SC—$580.03
SD—$580.03
TN—$580.03
TX—$580.03
UT—$580.03
VA—$580.03
VI$580.03—
VT—$580.03
WA—$580.03
WI—$580.03
WV—$580.03
WY—$580.03

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $539.41 to $647.25 depending on state and rural status.

Former-CBA payment limits: ceiling $539.41 · floor $458.50

StateNon-ruralRural
AK$539.41—
AL$539.41—
AR$539.41—
AZ$539.41—
CA$539.41—
CO$539.41—
CT$539.41—
DC$539.41—
DE$539.41—
FL$539.41—
GA$539.41—
HI$539.41—
IA$539.41—
ID$539.41—
IL$539.41—
IN$539.41—
KS$539.41—
KY$539.41—
LA$539.41—
MA$539.41—
MD$539.41—
ME$539.41—
MI$539.41—
MN$539.41—
MO$539.41—
MS$539.41—
MT$539.41—
NC$539.41—
ND$539.41—
NE$539.41—
NH$539.41—
NJ$539.41—
NM$539.41—
NV$539.41—
NY$539.41—
OH$539.41—
OK$539.41—
OR$539.41—
PA$539.41—
PR$647.25—
RI$539.41—
SC$539.41—
SD$539.41—
TN$539.41—
TX$539.41—
UT$539.41—
VA$539.41—
VI$539.41—
VT$539.41—
WA$539.41—
WI$539.41—
WV$539.41—
WY$539.41—
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 E1003 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

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E1002E1004E1005E1006E1007E1008E1009E1010E1011E1012E1014E1015

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