MyMedi-AI

E1224 — Wheelchair with detachable arms, elevating legrests

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

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 2026-10-25; 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 2026-10-25; 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.

E1224 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $98.31 to $139.00 depending on state and rural status.

Former-CBA payment limits: ceiling $115.66 · floor $98.31

StateNon-ruralRural
AK$106.36—
AL$115.66—
AR$115.66—
AZ$115.66—
CA$105.35—
CO$110.89—
CT$115.66—
DC$115.66—
DE$115.66—
FL$98.31—
GA$115.66—
HI$113.78—
IA$111.11—
ID$98.98—
IL$115.66—
IN$115.66—
KS$100.14—
KY$98.31—
LA$115.66—
MA$115.66—
MD$115.42—
ME$115.66—
MI$101.10—
MN$98.31—
MO$98.31—
MS$115.66—
MT$114.29—
NC$98.31—
ND$114.57—
NE$98.31—
NH$115.66—
NJ$115.66—
NM$105.38—
NV$115.66—
NY$98.31—
OH$115.66—
OK$100.93—
OR$98.31—
PA$115.66—
PR$139.00—
RI$98.31—
SC$115.66—
SD$115.66—
TN$98.31—
TX$115.66—
UT$98.31—
VA$115.66—
VI$98.31—
VT$115.66—
WA$115.66—
WI$98.31—
WV$100.57—
WY$115.66—
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 E1224 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

Bill E1224 with confidence

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