MyMedi-AI

E2325 — Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware

HCPCS Level II E-code · short descriptor: “Sip and puff interface”

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
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 2026-10-25; 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.

E2325 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $165.45 to $182.52 depending on state and rural status.

StateNon-ruralRural
AK$165.45—
AL$165.45$165.45
AR$165.45$165.45
AZ$165.45$165.45
CA$165.45$165.45
CO$165.45$165.45
CT$165.45$165.45
DC$165.45$165.45
DE$165.45$165.45
FL$165.45$165.45
GA$165.45$165.45
HI$165.45—
IA$165.45$165.45
ID$165.45$165.45
IL$165.45$165.45
IN$165.45$165.45
KS$165.45$165.45
KY$165.45$165.45
LA$165.45$165.45
MA$165.45$165.45
MD$165.45$165.45
ME$165.45$165.45
MI$165.45$165.45
MN$165.45$165.45
MO$165.45$165.45
MS$165.45$165.45
MT$165.45$165.45
NC$165.45$165.45
ND$165.45$165.45
NE$165.45$165.45
NH$165.45$165.45
NJ$165.45$165.45
NM$165.45$165.45
NV$165.45$165.45
NY$165.45$165.45
OH$165.45$165.45
OK$165.45$165.45
OR$165.45$165.45
PA$165.45$165.45
PR$182.52—
RI$165.45$165.45
SC$165.45$165.45
SD$165.45$165.45
TN$165.45$165.45
TX$165.45$165.45
UT$165.45$165.45
VA$165.45$165.45
VI$165.45—
VT$165.45$165.45
WA$165.45$165.45
WI$165.45$165.45
WV$165.45$165.45
WY$165.45$165.45

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $177.97 to $196.91 depending on state and rural status.

StateNon-ruralRural
AK$177.97—
AL—$177.97
AR—$177.97
AZ—$177.97
CA—$177.97
CO—$177.97
CT—$177.97
DC—$177.97
DE—$177.97
FL—$177.97
GA—$177.97
HI$177.97—
IA—$177.97
ID—$177.97
IL—$177.97
IN—$177.97
KS—$177.97
KY—$177.97
LA—$177.97
MA—$177.97
MD—$177.97
ME—$177.97
MI—$177.97
MN—$177.97
MO—$177.97
MS—$177.97
MT—$177.97
NC—$177.97
ND—$177.97
NE—$177.97
NH—$177.97
NJ—$177.97
NM—$177.97
NV—$177.97
NY—$177.97
OH—$177.97
OK—$177.97
OR—$177.97
PA—$177.97
PR$196.91—
RI—$177.97
SC—$177.97
SD—$177.97
TN—$177.97
TX—$177.97
UT—$177.97
VA—$177.97
VI$177.97—
VT—$177.97
WA—$177.97
WI—$177.97
WV—$177.97
WY—$177.97

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $165.44 to $198.54 depending on state and rural status.

Former-CBA payment limits: ceiling $165.44 · floor $140.62

StateNon-ruralRural
AK$165.44—
AL$165.44—
AR$165.44—
AZ$165.44—
CA$165.44—
CO$165.44—
CT$165.44—
DC$165.44—
DE$165.44—
FL$165.44—
GA$165.44—
HI$165.44—
IA$165.44—
ID$165.44—
IL$165.44—
IN$165.44—
KS$165.44—
KY$165.44—
LA$165.44—
MA$165.44—
MD$165.44—
ME$165.44—
MI$165.44—
MN$165.44—
MO$165.44—
MS$165.44—
MT$165.44—
NC$165.44—
ND$165.44—
NE$165.44—
NH$165.44—
NJ$165.44—
NM$165.44—
NV$165.44—
NY$165.44—
OH$165.44—
OK$165.44—
OR$165.44—
PA$165.44—
PR$198.54—
RI$165.44—
SC$165.44—
SD$165.44—
TN$165.44—
TX$165.44—
UT$165.44—
VA$165.44—
VI$165.44—
VT$165.44—
WA$165.44—
WI$165.44—
WV$165.44—
WY$165.44—
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 E2325 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

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E2301E2310E2311E2312E2313E2321E2322E2323E2324E2326E2327E2328

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