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E1030 — Wheelchair accessory, ventilator tray, gimbaled

HCPCS Level II E-code · short descriptor: “W/c vent tray gimbaled”

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.

E1030 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $143.14 to $159.10 depending on state and rural status.

StateNon-ruralRural
AK$143.14—
AL$143.14$143.14
AR$143.14$143.14
AZ$143.14$143.14
CA$143.14$143.14
CO$143.14$143.14
CT$143.14$143.14
DC$143.14$143.14
DE$143.14$143.14
FL$143.14$143.14
GA$143.14$143.14
HI$143.14—
IA$143.14$143.14
ID$143.14$143.14
IL$143.14$143.14
IN$143.14$143.14
KS$143.14$143.14
KY$143.14$143.14
LA$143.14$143.14
MA$143.14$143.14
MD$143.14$143.14
ME$143.14$143.14
MI$143.14$143.14
MN$143.14$143.14
MO$143.14$143.14
MS$143.14$143.14
MT$143.14$143.14
NC$143.14$143.14
ND$143.14$143.14
NE$143.14$143.14
NH$143.14$143.14
NJ$143.14$143.14
NM$143.14$143.14
NV$143.14$143.14
NY$143.14$143.14
OH$143.14$143.14
OK$143.14$143.14
OR$143.14$143.14
PA$143.14$143.14
PR$159.10—
RI$143.14$143.14
SC$143.14$143.14
SD$143.14$143.14
TN$143.14$143.14
TX$143.14$143.14
UT$143.14$143.14
VA$143.14$143.14
VI$143.14—
VT$143.14$143.14
WA$143.14$143.14
WI$143.14$143.14
WV$143.14$143.14
WY$143.14$143.14

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $154.43 to $171.56 depending on state and rural status.

StateNon-ruralRural
AK$155.16—
AL—$154.43
AR—$154.43
AZ—$154.43
CA—$154.43
CO—$154.43
CT—$154.43
DC—$154.43
DE—$154.43
FL—$154.43
GA—$154.43
HI$155.16—
IA—$154.43
ID—$154.43
IL—$154.43
IN—$154.43
KS—$154.43
KY—$154.43
LA—$154.43
MA—$154.43
MD—$154.43
ME—$154.43
MI—$154.43
MN—$154.43
MO—$154.43
MS—$154.43
MT—$154.43
NC—$154.43
ND—$154.43
NE—$154.43
NH—$154.43
NJ—$154.43
NM—$154.43
NV—$154.43
NY—$154.43
OH—$154.43
OK—$154.43
OR—$154.43
PA—$154.43
PR$171.56—
RI—$154.43
SC—$154.43
SD—$154.43
TN—$154.43
TX—$154.43
UT—$154.43
VA—$154.43
VI$155.16—
VT—$154.43
WA—$154.43
WI—$154.43
WV—$154.43
WY—$154.43

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $143.13 to $171.79 depending on state and rural status.

Former-CBA payment limits: ceiling $143.13 · floor $121.66

StateNon-ruralRural
AK$143.13—
AL$143.13—
AR$143.13—
AZ$143.13—
CA$143.13—
CO$143.13—
CT$143.13—
DC$143.13—
DE$143.13—
FL$143.13—
GA$143.13—
HI$143.13—
IA$143.13—
ID$143.13—
IL$143.13—
IN$143.13—
KS$143.13—
KY$143.13—
LA$143.13—
MA$143.13—
MD$143.13—
ME$143.13—
MI$143.13—
MN$143.13—
MO$143.13—
MS$143.13—
MT$143.13—
NC$143.13—
ND$143.13—
NE$143.13—
NH$143.13—
NJ$143.13—
NM$143.13—
NV$143.13—
NY$143.13—
OH$143.13—
OK$143.13—
OR$143.13—
PA$143.13—
PR$171.79—
RI$143.13—
SC$143.13—
SD$143.13—
TN$143.13—
TX$143.13—
UT$143.13—
VA$143.13—
VI$143.13—
VT$143.13—
WA$143.13—
WI$143.13—
WV$143.13—
WY$143.13—
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

E1002E1003E1004E1005E1006E1007E1008E1009E1010E1011E1012E1014

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