E1226 — Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
HCPCS Level II E-code · short descriptor: “Manual fully reclining back”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Inexpensive or routinely purchased
- 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.
E1226 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $419.38 to $1024.59 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $1024.59 | — |
| AL | $494.01 | $643.58 |
| AR | $494.01 | $643.58 |
| AZ | $448.17 | $585.26 |
| CA | $448.85 | $585.26 |
| CO | $472.35 | $585.26 |
| CT | $437.14 | $643.58 |
| DC | $419.38 | $643.58 |
| DE | $419.38 | $643.58 |
| FL | $494.01 | $585.26 |
| GA | $494.01 | $643.58 |
| HI | $781.34 | — |
| IA | $481.68 | $643.58 |
| ID | $472.35 | $643.58 |
| IL | $461.72 | $643.58 |
| IN | $461.72 | $643.58 |
| KS | $481.68 | $609.76 |
| KY | $494.01 | $643.58 |
| LA | $494.01 | $643.58 |
| MA | $437.14 | $585.26 |
| MD | $419.38 | $585.26 |
| ME | $437.14 | $585.26 |
| MI | $461.72 | $643.58 |
| MN | $481.68 | $643.58 |
| MO | $481.68 | $585.26 |
| MS | $494.01 | $643.58 |
| MT | $472.35 | $585.26 |
| NC | $494.01 | $585.26 |
| ND | $481.68 | $585.26 |
| NE | $481.68 | $643.58 |
| NH | $437.14 | $585.26 |
| NJ | $419.38 | $643.58 |
| NM | $448.17 | $643.58 |
| NV | $448.85 | $604.10 |
| NY | $419.38 | $643.58 |
| OH | $461.72 | $585.26 |
| OK | $448.17 | $643.58 |
| OR | $448.85 | $643.58 |
| PA | $419.38 | $585.26 |
| PR | $751.40 | — |
| RI | $437.14 | $585.26 |
| SC | $494.01 | $585.26 |
| SD | $481.68 | $585.26 |
| TN | $494.01 | $643.58 |
| TX | $448.17 | $585.26 |
| UT | $472.35 | $585.26 |
| VA | $494.01 | $643.58 |
| VI | $643.58 | — |
| VT | $437.14 | $585.26 |
| WA | $448.85 | $643.58 |
| WI | $461.72 | $643.58 |
| WV | $494.01 | $631.41 |
| WY | $472.35 | $585.26 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $660.99 to $1539.67 depending on state and rural status.
Former-CBA payment limits: ceiling $777.63 · floor $660.99
| State | Non-rural | Rural |
|---|---|---|
| AK | $1539.67 | — |
| AL | $777.63 | — |
| AR | $777.63 | — |
| AZ | $660.99 | — |
| CA | $660.99 | — |
| CO | $660.99 | — |
| CT | $777.63 | — |
| DC | $777.63 | — |
| DE | $777.63 | — |
| FL | $660.99 | — |
| GA | $777.63 | — |
| HI | $1053.17 | — |
| IA | $777.63 | — |
| ID | $777.63 | — |
| IL | $777.63 | — |
| IN | $777.63 | — |
| KS | $710.00 | — |
| KY | $777.63 | — |
| LA | $777.63 | — |
| MA | $660.99 | — |
| MD | $660.99 | — |
| ME | $660.99 | — |
| MI | $777.63 | — |
| MN | $777.63 | — |
| MO | $660.99 | — |
| MS | $777.63 | — |
| MT | $660.99 | — |
| NC | $660.99 | — |
| ND | $660.99 | — |
| NE | $777.63 | — |
| NH | $660.99 | — |
| NJ | $777.63 | — |
| NM | $777.63 | — |
| NV | $698.65 | — |
| NY | $777.63 | — |
| OH | $660.99 | — |
| OK | $777.63 | — |
| OR | $777.63 | — |
| PA | $660.99 | — |
| PR | $993.26 | — |
| RI | $660.99 | — |
| SC | $660.99 | — |
| SD | $660.99 | — |
| TN | $777.63 | — |
| TX | $660.99 | — |
| UT | $660.99 | — |
| VA | $777.63 | — |
| VI | $777.63 | — |
| VT | $660.99 | — |
| WA | $777.63 | — |
| WI | $777.63 | — |
| WV | $753.29 | — |
| WY | $660.99 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $41.94 to $102.46 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $102.46 | — |
| AL | $49.40 | $65.49 |
| AR | $49.40 | $65.49 |
| AZ | $44.82 | $65.49 |
| CA | $44.89 | $59.49 |
| CO | $47.23 | $59.49 |
| CT | $43.72 | $65.49 |
| DC | $41.94 | $65.49 |
| DE | $41.94 | $65.49 |
| FL | $49.40 | $59.49 |
| GA | $49.40 | $65.49 |
| HI | $78.12 | — |
| IA | $48.17 | $65.49 |
| ID | $47.23 | $65.49 |
| IL | $46.17 | $65.49 |
| IN | $46.17 | $65.49 |
| KS | $48.17 | $60.98 |
| KY | $49.40 | $65.49 |
| LA | $49.40 | $65.49 |
| MA | $43.72 | $59.49 |
| MD | $41.94 | $59.49 |
| ME | $43.72 | $59.49 |
| MI | $46.17 | $65.49 |
| MN | $48.17 | $65.49 |
| MO | $48.17 | $59.49 |
| MS | $49.40 | $65.49 |
| MT | $47.23 | $59.49 |
| NC | $49.40 | $59.49 |
| ND | $48.17 | $59.49 |
| NE | $48.17 | $64.35 |
| NH | $43.72 | $59.49 |
| NJ | $41.94 | $65.49 |
| NM | $44.82 | $65.49 |
| NV | $44.89 | $60.41 |
| NY | $41.94 | $65.49 |
| OH | $46.17 | $59.49 |
| OK | $44.82 | $65.49 |
| OR | $44.89 | $65.49 |
| PA | $41.94 | $59.49 |
| PR | $87.55 | — |
| RI | $43.72 | $59.49 |
| SC | $49.40 | $59.49 |
| SD | $48.17 | $59.49 |
| TN | $49.40 | $65.49 |
| TX | $44.82 | $59.49 |
| UT | $47.23 | $59.49 |
| VA | $49.40 | $65.49 |
| VI | $65.49 | — |
| VT | $43.72 | $59.49 |
| WA | $44.89 | $65.49 |
| WI | $46.17 | $65.49 |
| WV | $49.40 | $63.14 |
| WY | $47.23 | $59.49 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $68.02 to $153.98 depending on state and rural status.
Former-CBA payment limits: ceiling $80.02 · floor $68.02
| State | Non-rural | Rural |
|---|---|---|
| AK | $153.98 | — |
| AL | $80.02 | — |
| AR | $80.02 | — |
| AZ | $80.02 | — |
| CA | $68.02 | — |
| CO | $68.02 | — |
| CT | $80.02 | — |
| DC | $80.02 | — |
| DE | $80.02 | — |
| FL | $68.02 | — |
| GA | $80.02 | — |
| HI | $105.27 | — |
| IA | $80.02 | — |
| ID | $80.02 | — |
| IL | $80.02 | — |
| IN | $80.02 | — |
| KS | $71.01 | — |
| KY | $80.02 | — |
| LA | $80.02 | — |
| MA | $68.02 | — |
| MD | $68.02 | — |
| ME | $68.02 | — |
| MI | $80.02 | — |
| MN | $80.02 | — |
| MO | $68.02 | — |
| MS | $80.02 | — |
| MT | $68.02 | — |
| NC | $68.02 | — |
| ND | $68.02 | — |
| NE | $77.76 | — |
| NH | $68.02 | — |
| NJ | $80.02 | — |
| NM | $80.02 | — |
| NV | $69.88 | — |
| NY | $80.02 | — |
| OH | $68.02 | — |
| OK | $80.02 | — |
| OR | $80.02 | — |
| PA | $68.02 | — |
| PR | $124.12 | — |
| RI | $68.02 | — |
| SC | $68.02 | — |
| SD | $68.02 | — |
| TN | $80.02 | — |
| TX | $68.02 | — |
| UT | $68.02 | — |
| VA | $80.02 | — |
| VI | $80.02 | — |
| VT | $68.02 | — |
| WA | $80.02 | — |
| WI | $80.02 | — |
| WV | $75.35 | — |
| WY | $68.02 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $314.53 to $768.30 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $768.30 | — |
| AL | $370.51 | $482.66 |
| AR | $370.51 | $482.66 |
| AZ | $336.13 | $438.92 |
| CA | $336.64 | $438.92 |
| CO | $354.26 | $438.92 |
| CT | $327.86 | $482.66 |
| DC | $314.53 | $482.66 |
| DE | $314.53 | $482.66 |
| FL | $370.51 | $438.92 |
| GA | $370.51 | $482.66 |
| HI | $586.02 | — |
| IA | $361.26 | $482.66 |
| ID | $354.26 | $482.66 |
| IL | $346.29 | $482.66 |
| IN | $346.29 | $482.66 |
| KS | $361.26 | $457.34 |
| KY | $370.51 | $482.66 |
| LA | $370.51 | $482.66 |
| MA | $327.86 | $438.92 |
| MD | $314.53 | $438.92 |
| ME | $327.86 | $438.92 |
| MI | $346.29 | $482.66 |
| MN | $361.26 | $482.66 |
| MO | $361.26 | $444.80 |
| MS | $370.51 | $482.66 |
| MT | $354.26 | $438.92 |
| NC | $370.51 | $438.92 |
| ND | $361.26 | $438.92 |
| NE | $361.26 | $482.66 |
| NH | $327.86 | $438.92 |
| NJ | $314.53 | $482.66 |
| NM | $336.13 | $482.66 |
| NV | $336.64 | $453.07 |
| NY | $314.53 | $482.66 |
| OH | $346.29 | $438.92 |
| OK | $336.13 | $482.66 |
| OR | $336.64 | $482.66 |
| PA | $314.53 | $438.92 |
| PR | $563.54 | — |
| RI | $327.86 | $438.92 |
| SC | $370.51 | $438.92 |
| SD | $361.26 | $438.92 |
| TN | $370.51 | $482.66 |
| TX | $336.13 | $438.92 |
| UT | $354.26 | $438.92 |
| VA | $370.51 | $482.66 |
| VI | $482.66 | — |
| VT | $327.86 | $438.92 |
| WA | $336.64 | $482.66 |
| WI | $346.29 | $482.66 |
| WV | $370.51 | $473.56 |
| WY | $354.26 | $438.92 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $495.68 to $1154.46 depending on state and rural status.
Former-CBA payment limits: ceiling $583.15 · floor $495.68
| State | Non-rural | Rural |
|---|---|---|
| AK | $1154.46 | — |
| AL | $583.15 | — |
| AR | $583.15 | — |
| AZ | $495.68 | — |
| CA | $495.68 | — |
| CO | $495.68 | — |
| CT | $583.15 | — |
| DC | $583.15 | — |
| DE | $583.15 | — |
| FL | $495.68 | — |
| GA | $583.15 | — |
| HI | $789.88 | — |
| IA | $583.15 | — |
| ID | $583.15 | — |
| IL | $583.15 | — |
| IN | $583.15 | — |
| KS | $532.52 | — |
| KY | $583.15 | — |
| LA | $583.15 | — |
| MA | $495.68 | — |
| MD | $495.68 | — |
| ME | $495.68 | — |
| MI | $583.15 | — |
| MN | $583.15 | — |
| MO | $507.46 | — |
| MS | $583.15 | — |
| MT | $495.68 | — |
| NC | $495.68 | — |
| ND | $495.68 | — |
| NE | $583.15 | — |
| NH | $495.68 | — |
| NJ | $583.15 | — |
| NM | $583.15 | — |
| NV | $524.00 | — |
| NY | $583.15 | — |
| OH | $495.68 | — |
| OK | $583.15 | — |
| OR | $583.15 | — |
| PA | $495.68 | — |
| PR | $744.94 | — |
| RI | $495.68 | — |
| SC | $495.68 | — |
| SD | $495.68 | — |
| TN | $583.15 | — |
| TX | $495.68 | — |
| UT | $495.68 | — |
| VA | $583.15 | — |
| VI | $583.15 | — |
| VT | $495.68 | — |
| WA | $583.15 | — |
| WI | $583.15 | — |
| WV | $564.97 | — |
| WY | $495.68 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E1226 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 E1226 with confidence
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