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E1195 — Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests

HCPCS Level II E-code · short descriptor: “Wheelchair amputee heavy dut”

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
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.

E1195 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $152.17 to $210.59 depending on state and rural status.

Former-CBA payment limits: ceiling $179.02 · floor $152.17

StateNon-ruralRural
AK$196.99
AL$156.11
AR$152.17
AZ$179.02
CA$179.02
CO$179.02
CT$179.02
DC$179.02
DE$152.17
FL$152.17
GA$152.17
HI$210.59
IA$177.77
ID$179.02
IL$152.17
IN$160.70
KS$179.02
KY$179.02
LA$164.86
MA$179.02
MD$165.39
ME$179.02
MI$152.17
MN$152.17
MO$179.02
MS$152.17
MT$175.25
NC$152.17
ND$179.02
NE$179.02
NH$179.02
NJ$152.17
NM$179.02
NV$179.02
NY$179.02
OH$152.17
OK$179.02
OR$153.70
PA$152.17
PR$183.67
RI$152.17
SC$152.17
SD$179.02
TN$179.02
TX$179.02
UT$152.17
VA$158.65
VI$179.02
VT$179.02
WA$179.02
WI$179.02
WV$152.17
WY$179.02
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

Related E-codes

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