MyMedi-AI

E1005 — Wheelchair accessory, power seating system, recline only, with power shear reduction

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

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.

E1005 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $647.36 to $714.54 depending on state and rural status.

StateNon-ruralRural
AK$647.36—
AL$647.36$647.36
AR$647.36$647.36
AZ$647.36$647.36
CA$647.36$647.36
CO$647.36$647.36
CT$647.36$647.36
DC$647.36$647.36
DE$647.36$647.36
FL$647.36$647.36
GA$647.36$647.36
HI$647.36—
IA$647.36$647.36
ID$647.36$647.36
IL$647.36$647.36
IN$647.36$647.36
KS$647.36$647.36
KY$647.36$647.36
LA$647.36$647.36
MA$647.36$647.36
MD$647.36$647.36
ME$647.36$647.36
MI$647.36$647.36
MN$647.36$647.36
MO$647.36$647.36
MS$647.36$647.36
MT$647.36$647.36
NC$647.36$647.36
ND$647.36$647.36
NE$647.36$647.36
NH$647.36$647.36
NJ$647.36$647.36
NM$647.36$647.36
NV$647.36$647.36
NY$647.36$647.36
OH$647.36$647.36
OK$647.36$647.36
OR$647.36$647.36
PA$647.36$647.36
PR$714.54—
RI$647.36$647.36
SC$647.36$647.36
SD$647.36$647.36
TN$647.36$647.36
TX$647.36$647.36
UT$647.36$647.36
VA$647.36$647.36
VI$647.36—
VT$647.36$647.36
WA$647.36$647.36
WI$647.36$647.36
WV$647.36$647.36
WY$647.36$647.36

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $696.72 to $770.86 depending on state and rural status.

StateNon-ruralRural
AK$696.72—
AL—$696.72
AR—$696.72
AZ—$696.72
CA—$696.72
CO—$696.72
CT—$696.72
DC—$696.72
DE—$696.72
FL—$696.72
GA—$696.72
HI$696.72—
IA—$696.72
ID—$696.72
IL—$696.72
IN—$696.72
KS—$696.72
KY—$696.72
LA—$696.72
MA—$696.72
MD—$696.72
ME—$696.72
MI—$696.72
MN—$696.72
MO—$696.72
MS—$696.72
MT—$696.72
NC—$696.72
ND—$696.72
NE—$696.72
NH—$696.72
NJ—$696.72
NM—$696.72
NV—$696.72
NY—$696.72
OH—$696.72
OK—$696.72
OR—$696.72
PA—$696.72
PR$770.86—
RI—$696.72
SC—$696.72
SD—$696.72
TN—$696.72
TX—$696.72
UT—$696.72
VA—$696.72
VI$696.72—
VT—$696.72
WA—$696.72
WI—$696.72
WV—$696.72
WY—$696.72

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $647.38 to $776.87 depending on state and rural status.

Former-CBA payment limits: ceiling $647.38 · floor $550.27

StateNon-ruralRural
AK$647.38—
AL$647.38—
AR$647.38—
AZ$647.38—
CA$647.38—
CO$647.38—
CT$647.38—
DC$647.38—
DE$647.38—
FL$647.38—
GA$647.38—
HI$647.38—
IA$647.38—
ID$647.38—
IL$647.38—
IN$647.38—
KS$647.38—
KY$647.38—
LA$647.38—
MA$647.38—
MD$647.38—
ME$647.38—
MI$647.38—
MN$647.38—
MO$647.38—
MS$647.38—
MT$647.38—
NC$647.38—
ND$647.38—
NE$647.38—
NH$647.38—
NJ$647.38—
NM$647.38—
NV$647.38—
NY$647.38—
OH$647.38—
OK$647.38—
OR$647.38—
PA$647.38—
PR$776.87—
RI$647.38—
SC$647.38—
SD$647.38—
TN$647.38—
TX$647.38—
UT$647.38—
VA$647.38—
VI$647.38—
VT$647.38—
WA$647.38—
WI$647.38—
WV$647.38—
WY$647.38—
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 E1005 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

E1002E1003E1004E1006E1007E1008E1009E1010E1011E1012E1014E1015

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