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E1004 — Wheelchair accessory, power seating system, recline only, with mechanical shear reduction

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

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
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

E1004 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $596.22 to $656.96 depending on state and rural status.

StateNon-ruralRural
AK$597.14—
AL$596.22$597.14
AR$596.22$597.14
AZ$596.22$597.14
CA$596.22$597.14
CO$596.22$597.14
CT$596.22$597.14
DC$596.22$597.14
DE$596.22$597.14
FL$596.22$597.14
GA$596.22$597.14
HI$597.14—
IA$596.22$597.14
ID$596.22$597.14
IL$596.22$597.14
IN$596.22$597.14
KS$596.22$597.14
KY$596.22$597.14
LA$596.22$597.14
MA$596.22$597.14
MD$596.22$597.14
ME$596.22$597.14
MI$596.22$597.14
MN$596.22$597.14
MO$596.22$597.14
MS$596.22$597.14
MT$596.22$597.14
NC$596.22$597.14
ND$596.22$597.14
NE$596.22$597.14
NH$596.22$597.14
NJ$596.22$597.14
NM$596.22$597.14
NV$596.22$597.14
NY$596.22$597.14
OH$596.22$597.14
OK$596.22$597.14
OR$596.22$597.14
PA$596.22$597.14
PR$656.96—
RI$596.22$597.14
SC$596.22$597.14
SD$596.22$597.14
TN$596.22$597.14
TX$596.22$597.14
UT$596.22$597.14
VA$596.22$597.14
VI$597.14—
VT$596.22$597.14
WA$596.22$597.14
WI$596.22$597.14
WV$596.22$597.14
WY$596.22$597.14

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $640.50 to $708.99 depending on state and rural status.

StateNon-ruralRural
AK$640.50—
AL—$640.50
AR—$640.50
AZ—$640.50
CA—$640.50
CO—$640.50
CT—$640.50
DC—$640.50
DE—$640.50
FL—$640.50
GA—$640.50
HI$640.50—
IA—$640.50
ID—$640.50
IL—$640.50
IN—$640.50
KS—$640.50
KY—$640.50
LA—$640.50
MA—$640.50
MD—$640.50
ME—$640.50
MI—$640.50
MN—$640.50
MO—$640.50
MS—$640.50
MT—$640.50
NC—$640.50
ND—$640.50
NE—$640.50
NH—$640.50
NJ—$640.50
NM—$640.50
NV—$640.50
NY—$640.50
OH—$640.50
OK—$640.50
OR—$640.50
PA—$640.50
PR$708.99—
RI—$640.50
SC—$640.50
SD—$640.50
TN—$640.50
TX—$640.50
UT—$640.50
VA—$640.50
VI$640.50—
VT—$640.50
WA—$640.50
WI—$640.50
WV—$640.50
WY—$640.50

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $598.07 to $717.70 depending on state and rural status.

Former-CBA payment limits: ceiling $598.07 · floor $508.36

StateNon-ruralRural
AK$598.07—
AL$598.07—
AR$598.07—
AZ$598.07—
CA$598.07—
CO$598.07—
CT$598.07—
DC$598.07—
DE$598.07—
FL$598.07—
GA$598.07—
HI$598.07—
IA$598.07—
ID$598.07—
IL$598.07—
IN$598.07—
KS$598.07—
KY$598.07—
LA$598.07—
MA$598.07—
MD$598.07—
ME$598.07—
MI$598.07—
MN$598.07—
MO$598.07—
MS$598.07—
MT$598.07—
NC$598.07—
ND$598.07—
NE$598.07—
NH$598.07—
NJ$598.07—
NM$598.07—
NV$598.07—
NY$598.07—
OH$598.07—
OK$598.07—
OR$598.07—
PA$598.07—
PR$717.70—
RI$598.07—
SC$598.07—
SD$598.07—
TN$598.07—
TX$598.07—
UT$598.07—
VA$598.07—
VI$598.07—
VT$598.07—
WA$598.07—
WI$598.07—
WV$598.07—
WY$598.07—
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

Common denial codes to watch

CO-50 medical necessity

Related E-codes

E1002E1003E1005E1006E1007E1008E1009E1010E1011E1012E1014E1015

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