MyMedi-AI

E1820 — Replacement soft interface material, dynamic adjustable extension/flexion device

HCPCS Level II E-code · short descriptor: “Soft interface material”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
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
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 2026-10-26; 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.

E1820 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $109.91 to $144.41 depending on state and rural status.

Former-CBA payment limits: ceiling $116.50 · floor $99.03

StateNon-ruralRural
AK$110.98—
AL$116.50—
AR$116.50—
AZ$109.91—
CA$109.91—
CO$116.50—
CT$116.50—
DC$109.91—
DE$116.50—
FL$116.50—
GA$116.50—
HI$118.69—
IA$109.91—
ID$109.91—
IL$109.91—
IN$115.42—
KS$109.91—
KY$116.50—
LA$116.50—
MA$116.50—
MD$109.91—
ME$116.50—
MI$114.30—
MN$116.50—
MO$114.30—
MS$116.50—
MT$109.91—
NC$116.50—
ND$109.91—
NE$109.91—
NH$116.50—
NJ$116.50—
NM$116.50—
NV$109.91—
NY$116.50—
OH$109.91—
OK$116.50—
OR$109.91—
PA$116.50—
PR$144.41—
RI$116.50—
SC$116.50—
SD$109.91—
TN$116.50—
TX$116.50—
UT$115.42—
VA$109.91—
VI$116.50—
VT$116.50—
WA$109.91—
WI$115.42—
WV$109.91—
WY$109.91—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $11.01 to $14.44 depending on state and rural status.

Former-CBA payment limits: ceiling $11.63 · floor $9.89

StateNon-ruralRural
AK$11.09—
AL$11.63—
AR$11.63—
AZ$11.01—
CA$11.01—
CO$11.63—
CT$11.63—
DC$11.01—
DE$11.63—
FL$11.63—
GA$11.63—
HI$11.87—
IA$11.01—
ID$11.01—
IL$11.01—
IN$11.55—
KS$11.01—
KY$11.63—
LA$11.63—
MA$11.63—
MD$11.01—
ME$11.63—
MI$11.45—
MN$11.63—
MO$11.45—
MS$11.63—
MT$11.01—
NC$11.63—
ND$11.01—
NE$11.01—
NH$11.63—
NJ$11.63—
NM$11.63—
NV$11.01—
NY$11.63—
OH$11.01—
OK$11.63—
OR$11.01—
PA$11.63—
PR$14.44—
RI$11.63—
SC$11.63—
SD$11.01—
TN$11.63—
TX$11.63—
UT$11.55—
VA$11.01—
VI$11.63—
VT$11.63—
WA$11.01—
WI$11.55—
WV$11.01—
WY$11.01—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $82.43 to $108.30 depending on state and rural status.

Former-CBA payment limits: ceiling $87.39 · floor $74.28

StateNon-ruralRural
AK$83.26—
AL$87.39—
AR$87.39—
AZ$82.43—
CA$82.43—
CO$87.39—
CT$87.39—
DC$82.43—
DE$87.39—
FL$87.39—
GA$87.39—
HI$89.02—
IA$82.43—
ID$82.43—
IL$82.43—
IN$86.55—
KS$82.43—
KY$87.39—
LA$87.39—
MA$87.39—
MD$82.43—
ME$87.39—
MI$85.72—
MN$87.39—
MO$85.72—
MS$87.39—
MT$82.43—
NC$87.39—
ND$82.43—
NE$82.43—
NH$87.39—
NJ$87.39—
NM$87.39—
NV$82.43—
NY$87.39—
OH$82.43—
OK$87.39—
OR$82.43—
PA$87.39—
PR$108.30—
RI$87.39—
SC$87.39—
SD$82.43—
TN$87.39—
TX$87.39—
UT$86.55—
VA$82.43—
VI$87.39—
VT$87.39—
WA$82.43—
WI$86.55—
WV$82.43—
WY$82.43—
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 E1820 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Clinical: Data.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E1800E1801E1802E1803E1804E1805E1806E1807E1808E1810E1811E1812

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