MyMedi-AI

E1092 — Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests

HCPCS Level II E-code · short descriptor: “Wheelchair wide w/ leg rests”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
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.

E1092 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $155.68 to $243.20 depending on state and rural status.

Former-CBA payment limits: ceiling $183.15 · floor $155.68

StateNon-ruralRural
AK$163.17—
AL$155.68—
AR$155.68—
AZ$183.15—
CA$161.55—
CO$155.68—
CT$183.15—
DC$183.15—
DE$183.15—
FL$155.68—
GA$183.15—
HI$174.48—
IA$180.59—
ID$183.15—
IL$183.15—
IN$183.15—
KS$183.15—
KY$164.78—
LA$164.86—
MA$155.68—
MD$155.68—
ME$155.68—
MI$155.68—
MN$183.15—
MO$155.68—
MS$179.25—
MT$183.15—
NC$183.15—
ND$161.65—
NE$183.15—
NH$155.68—
NJ$183.15—
NM$183.15—
NV$183.15—
NY$183.15—
OH$159.45—
OK$183.15—
OR$183.15—
PA$183.15—
PR$243.20—
RI$155.68—
SC$183.15—
SD$176.07—
TN$183.15—
TX$183.15—
UT$155.68—
VA$163.43—
VI$183.15—
VT$155.68—
WA$183.15—
WI$183.15—
WV$155.68—
WY$175.54—
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 E1092 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

Related E-codes

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