MyMedi-AI

E1812 — Dynamic knee, extension/flexion device with active resistance control

HCPCS Level II E-code · short descriptor: “Knee ext/flex w act res ctrl”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
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
2
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.

E1812 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $122.55 to $147.07 depending on state and rural status.

Former-CBA payment limits: ceiling $122.55 · floor $104.17

StateNon-ruralRural
AK$122.55—
AL$122.55—
AR$122.55—
AZ$122.55—
CA$122.55—
CO$122.55—
CT$122.55—
DC$122.55—
DE$122.55—
FL$122.55—
GA$122.55—
HI$122.55—
IA$122.55—
ID$122.55—
IL$122.55—
IN$122.55—
KS$122.55—
KY$122.55—
LA$122.55—
MA$122.55—
MD$122.55—
ME$122.55—
MI$122.55—
MN$122.55—
MO$122.55—
MS$122.55—
MT$122.55—
NC$122.55—
ND$122.55—
NE$122.55—
NH$122.55—
NJ$122.55—
NM$122.55—
NV$122.55—
NY$122.55—
OH$122.55—
OK$122.55—
OR$122.55—
PA$122.55—
PR$147.07—
RI$122.55—
SC$122.55—
SD$122.55—
TN$122.55—
TX$122.55—
UT$122.55—
VA$122.55—
VI$122.55—
VT$122.55—
WA$122.55—
WI$122.55—
WV$122.55—
WY$122.55—
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 E1812 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related E-codes

Bill E1812 with confidence

Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, E1812 included, and starter credits via POST /bot-marketplace/register.