MyMedi-AI

E2378 — Power wheelchair component, actuator, replacement only

HCPCS Level II E-code · short descriptor: “Pw actuator replacement”

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 2026-10-26; 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.

E2378 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $66.89 to $81.81 depending on state and rural status.

StateNon-ruralRural
AK$72.63—
AL$70.14$72.63
AR$70.14$72.63
AZ$66.89$72.63
CA$67.09$72.63
CO$70.66$72.63
CT$71.84$72.63
DC$67.24$72.63
DE$67.24$72.63
FL$70.14$72.63
GA$70.14$72.63
HI$72.63—
IA$70.73$72.63
ID$70.66$72.63
IL$68.86$72.63
IN$68.86$72.63
KS$70.73$72.63
KY$70.14$72.63
LA$70.14$72.63
MA$71.84$72.63
MD$67.24$72.63
ME$71.84$72.63
MI$68.86$72.63
MN$70.73$72.63
MO$70.73$72.63
MS$70.14$72.63
MT$70.66$72.63
NC$70.14$72.63
ND$70.73$72.63
NE$70.73$72.63
NH$71.84$72.63
NJ$67.24$72.63
NM$66.89$72.63
NV$67.09$72.63
NY$67.24$72.63
OH$68.86$72.63
OK$66.89$72.63
OR$67.09$72.63
PA$67.24$72.63
PR$81.81—
RI$71.84$72.63
SC$70.14$72.63
SD$70.73$72.63
TN$70.14$72.63
TX$66.89$72.63
UT$70.66$72.63
VA$70.14$72.63
VI$72.63—
VT$71.84$72.63
WA$67.09$72.63
WI$68.86$72.63
WV$70.14$72.63
WY$70.66$72.63

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $72.94 to $87.55 depending on state and rural status.

Former-CBA payment limits: ceiling $72.94 · floor $62.00

StateNon-ruralRural
AK$72.94—
AL$72.94—
AR$72.94—
AZ$72.94—
CA$72.94—
CO$72.94—
CT$72.94—
DC$72.94—
DE$72.94—
FL$72.94—
GA$72.94—
HI$72.94—
IA$72.94—
ID$72.94—
IL$72.94—
IN$72.94—
KS$72.94—
KY$72.94—
LA$72.94—
MA$72.94—
MD$72.94—
ME$72.94—
MI$72.94—
MN$72.94—
MO$72.94—
MS$72.94—
MT$72.94—
NC$72.94—
ND$72.94—
NE$72.94—
NH$72.94—
NJ$72.94—
NM$72.94—
NV$72.94—
NY$72.94—
OH$72.94—
OK$72.94—
OR$72.94—
PA$72.94—
PR$87.55—
RI$72.94—
SC$72.94—
SD$72.94—
TN$72.94—
TX$72.94—
UT$72.94—
VA$72.94—
VI$72.94—
VT$72.94—
WA$72.94—
WI$72.94—
WV$72.94—
WY$72.94—
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 E2378 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Nature of Equipment.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E2301E2310E2311E2312E2313E2321E2322E2323E2324E2325E2326E2327

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