MyMedi-AI

E1221 — Wheelchair with fixed arm, footrests

HCPCS Level II E-code · short descriptor: “Wheelchair spec size w foot”

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
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.

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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

E1221 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $57.56 to $87.75 depending on state and rural status.

Former-CBA payment limits: ceiling $67.72 · floor $57.56

StateNon-ruralRural
AK$68.41—
AL$67.72—
AR$61.61—
AZ$67.72—
CA$67.72—
CO$67.72—
CT$57.56—
DC$67.72—
DE$67.72—
FL$57.56—
GA$67.72—
HI$73.16—
IA$67.72—
ID$57.56—
IL$67.72—
IN$57.56—
KS$58.94—
KY$57.56—
LA$57.56—
MA$67.72—
MD$67.72—
ME$67.71—
MI$60.74—
MN$57.56—
MO$57.56—
MS$67.72—
MT$67.72—
NC$57.56—
ND$67.72—
NE$61.02—
NH$65.22—
NJ$59.74—
NM$57.56—
NV$67.72—
NY$67.72—
OH$67.72—
OK$57.56—
OR$67.72—
PA$57.56—
PR$87.75—
RI$57.56—
SC$67.72—
SD$67.72—
TN$59.67—
TX$67.72—
UT$61.49—
VA$67.72—
VI$67.72—
VT$67.72—
WA$58.92—
WI$67.72—
WV$67.37—
WY$67.72—
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

E1200E1220E1222E1223E1224E1225E1226E1227E1228E1229E1230E1231

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