E1236 — Wheelchair, pediatric size, folding, adjustable, with seating system
HCPCS Level II E-code · short descriptor: “Folding ped wc adjustable”
- 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.
E1236 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $233.55 to $280.26 depending on state and rural status.
Former-CBA payment limits: ceiling $233.55 · floor $198.52
| State | Non-rural | Rural |
|---|---|---|
| AK | $233.55 | — |
| AL | $233.55 | — |
| AR | $233.55 | — |
| AZ | $233.55 | — |
| CA | $233.55 | — |
| CO | $233.55 | — |
| CT | $233.55 | — |
| DC | $233.55 | — |
| DE | $233.55 | — |
| FL | $233.55 | — |
| GA | $233.55 | — |
| HI | $233.55 | — |
| IA | $233.55 | — |
| ID | $233.55 | — |
| IL | $233.55 | — |
| IN | $233.55 | — |
| KS | $233.55 | — |
| KY | $233.55 | — |
| LA | $233.55 | — |
| MA | $233.55 | — |
| MD | $233.55 | — |
| ME | $233.55 | — |
| MI | $233.55 | — |
| MN | $233.55 | — |
| MO | $233.55 | — |
| MS | $233.55 | — |
| MT | $233.55 | — |
| NC | $233.55 | — |
| ND | $233.55 | — |
| NE | $233.55 | — |
| NH | $233.55 | — |
| NJ | $233.55 | — |
| NM | $233.55 | — |
| NV | $233.55 | — |
| NY | $233.55 | — |
| OH | $233.55 | — |
| OK | $233.55 | — |
| OR | $233.55 | — |
| PA | $233.55 | — |
| PR | $280.26 | — |
| RI | $233.55 | — |
| SC | $233.55 | — |
| SD | $233.55 | — |
| TN | $233.55 | — |
| TX | $233.55 | — |
| UT | $233.55 | — |
| VA | $233.55 | — |
| VI | $233.55 | — |
| VT | $233.55 | — |
| WA | $233.55 | — |
| WI | $233.55 | — |
| WV | $233.55 | — |
| WY | $233.55 | — |
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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