E1225 — Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
HCPCS Level II E-code · short descriptor: “Manual semi-reclining back”
- 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.
E1225 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $43.15 to $61.82 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $49.78 | — |
| AL | $46.81 | $52.76 |
| AR | $46.81 | $56.21 |
| AZ | $44.86 | $57.41 |
| CA | $44.08 | $52.76 |
| CO | $47.43 | $56.74 |
| CT | $43.15 | $57.59 |
| DC | $43.90 | $57.59 |
| DE | $43.90 | $57.59 |
| FL | $46.81 | $52.76 |
| GA | $46.81 | $54.32 |
| HI | $53.12 | — |
| IA | $48.21 | $57.59 |
| ID | $47.43 | $57.59 |
| IL | $49.41 | $57.59 |
| IN | $49.41 | $57.59 |
| KS | $48.21 | $57.59 |
| KY | $46.81 | $57.59 |
| LA | $46.81 | $54.38 |
| MA | $43.15 | $52.76 |
| MD | $43.90 | $57.59 |
| ME | $43.15 | $52.76 |
| MI | $49.41 | $56.91 |
| MN | $48.21 | $57.59 |
| MO | $48.21 | $57.59 |
| MS | $46.81 | $54.28 |
| MT | $47.43 | $57.59 |
| NC | $46.81 | $52.76 |
| ND | $48.21 | $55.36 |
| NE | $48.21 | $57.59 |
| NH | $43.15 | $52.76 |
| NJ | $43.90 | $57.59 |
| NM | $44.86 | $55.88 |
| NV | $44.08 | $57.59 |
| NY | $43.90 | $57.59 |
| OH | $49.41 | $57.59 |
| OK | $44.86 | $56.31 |
| OR | $44.08 | $57.59 |
| PA | $43.90 | $57.59 |
| PR | $61.82 | — |
| RI | $43.15 | $52.76 |
| SC | $46.81 | $53.84 |
| SD | $48.21 | $57.59 |
| TN | $46.81 | $52.76 |
| TX | $44.86 | $52.76 |
| UT | $47.43 | $57.59 |
| VA | $46.81 | $54.30 |
| VI | $58.72 | — |
| VT | $43.15 | $52.76 |
| WA | $44.08 | $57.59 |
| WI | $49.41 | $53.06 |
| WV | $46.81 | $57.59 |
| WY | $47.43 | $57.59 |
RR + KU — Monthly rental Capped rental
Medicare allowable ranges from $49.77 to $70.60 depending on state and rural status.
Former-CBA payment limits: ceiling $64.41 · floor $54.75
| State | Non-rural | Rural |
|---|---|---|
| AK | $49.77 | — |
| AL | $54.75 | — |
| AR | $61.66 | — |
| AZ | $64.05 | — |
| CA | $54.75 | — |
| CO | $62.70 | — |
| CT | $64.41 | — |
| DC | $64.41 | — |
| DE | $64.41 | — |
| FL | $54.75 | — |
| GA | $57.86 | — |
| HI | $53.24 | — |
| IA | $64.41 | — |
| ID | $64.41 | — |
| IL | $64.41 | — |
| IN | $64.41 | — |
| KS | $64.41 | — |
| KY | $64.41 | — |
| LA | $57.97 | — |
| MA | $54.75 | — |
| MD | $64.41 | — |
| ME | $54.75 | — |
| MI | $63.06 | — |
| MN | $64.41 | — |
| MO | $64.41 | — |
| MS | $57.79 | — |
| MT | $64.41 | — |
| NC | $54.75 | — |
| ND | $59.97 | — |
| NE | $64.41 | — |
| NH | $54.75 | — |
| NJ | $64.41 | — |
| NM | $61.00 | — |
| NV | $64.41 | — |
| NY | $64.41 | — |
| OH | $64.41 | — |
| OK | $61.86 | — |
| OR | $64.41 | — |
| PA | $64.41 | — |
| PR | $70.60 | — |
| RI | $54.75 | — |
| SC | $56.91 | — |
| SD | $64.41 | — |
| TN | $54.75 | — |
| TX | $54.75 | — |
| UT | $64.41 | — |
| VA | $57.82 | — |
| VI | $64.41 | — |
| VT | $54.75 | — |
| WA | $64.41 | — |
| WI | $55.37 | — |
| WV | $64.41 | — |
| WY | $64.41 | — |
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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