MyMedi-AI

E2388 — Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each

HCPCS Level II E-code · short descriptor: “Foam drive wheel tire”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
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 2026-10-25; 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.

E2388 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $59.52 to $63.80 depending on state and rural status.

StateNon-ruralRural
AK$60.70—
AL$59.52$60.70
AR$59.52$60.70
AZ$59.52$60.70
CA$59.52$60.70
CO$59.52$60.70
CT$59.52$60.70
DC$59.52$60.70
DE$59.52$60.70
FL$59.52$60.70
GA$59.52$60.70
HI$60.70—
IA$59.52$60.70
ID$59.52$60.70
IL$59.52$60.70
IN$59.52$60.70
KS$59.52$60.70
KY$59.52$60.70
LA$59.52$60.70
MA$59.52$60.70
MD$59.52$60.70
ME$59.52$60.70
MI$59.52$60.70
MN$59.52$60.70
MO$59.52$60.70
MS$59.52$60.70
MT$59.52$60.70
NC$59.52$60.70
ND$59.52$60.70
NE$59.52$60.70
NH$59.52$60.70
NJ$59.52$60.70
NM$59.52$60.70
NV$59.52$60.70
NY$59.52$60.70
OH$59.52$60.70
OK$59.52$60.70
OR$59.52$60.70
PA$59.52$60.70
PR$63.80—
RI$59.52$60.70
SC$59.52$60.70
SD$59.52$60.70
TN$59.52$60.70
TX$59.52$60.70
UT$59.52$60.70
VA$59.52$60.70
VI$60.70—
VT$59.52$60.70
WA$59.52$60.70
WI$59.52$60.70
WV$59.52$60.70
WY$59.52$60.70

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $65.18 to $68.74 depending on state and rural status.

StateNon-ruralRural
AK$65.18—
AL—$65.18
AR—$65.18
AZ—$65.18
CA—$65.18
CO—$65.18
CT—$65.18
DC—$65.18
DE—$65.18
FL—$65.18
GA—$65.18
HI$65.18—
IA—$65.18
ID—$65.18
IL—$65.18
IN—$65.18
KS—$65.18
KY—$65.18
LA—$65.18
MA—$65.18
MD—$65.18
ME—$65.18
MI—$65.18
MN—$65.18
MO—$65.18
MS—$65.18
MT—$65.18
NC—$65.18
ND—$65.18
NE—$65.18
NH—$65.18
NJ—$65.18
NM—$65.18
NV—$65.18
NY—$65.18
OH—$65.18
OK—$65.18
OR—$65.18
PA—$65.18
PR$68.74—
RI—$65.18
SC—$65.18
SD—$65.18
TN—$65.18
TX—$65.18
UT—$65.18
VA—$65.18
VI$65.18—
VT—$65.18
WA—$65.18
WI—$65.18
WV—$65.18
WY—$65.18

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $61.87 to $68.12 depending on state and rural status.

Former-CBA payment limits: ceiling $61.87 · floor $52.59

StateNon-ruralRural
AK$61.87—
AL$61.87—
AR$61.87—
AZ$61.87—
CA$61.87—
CO$61.87—
CT$61.87—
DC$61.87—
DE$61.87—
FL$61.87—
GA$61.87—
HI$61.87—
IA$61.87—
ID$61.87—
IL$61.87—
IN$61.87—
KS$61.87—
KY$61.87—
LA$61.87—
MA$61.87—
MD$61.87—
ME$61.87—
MI$61.87—
MN$61.87—
MO$61.87—
MS$61.87—
MT$61.87—
NC$61.87—
ND$61.87—
NE$61.87—
NH$61.87—
NJ$61.87—
NM$61.87—
NV$61.87—
NY$61.87—
OH$61.87—
OK$61.87—
OR$61.87—
PA$61.87—
PR$68.12—
RI$61.87—
SC$61.87—
SD$61.87—
TN$61.87—
TX$61.87—
UT$61.87—
VA$61.87—
VI$61.87—
VT$61.87—
WA$61.87—
WI$61.87—
WV$61.87—
WY$61.87—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $5.95 to $6.37 depending on state and rural status.

StateNon-ruralRural
AK$6.08—
AL$5.95$6.08
AR$5.95$6.08
AZ$5.95$6.08
CA$5.95$6.08
CO$5.95$6.08
CT$5.95$6.08
DC$5.95$6.08
DE$5.95$6.08
FL$5.95$6.08
GA$5.95$6.08
HI$6.08—
IA$5.95$6.08
ID$5.95$6.08
IL$5.95$6.08
IN$5.95$6.08
KS$5.95$6.08
KY$5.95$6.08
LA$5.95$6.08
MA$5.95$6.08
MD$5.95$6.08
ME$5.95$6.08
MI$5.95$6.08
MN$5.95$6.08
MO$5.95$6.08
MS$5.95$6.08
MT$5.95$6.08
NC$5.95$6.08
ND$5.95$6.08
NE$5.95$6.08
NH$5.95$6.08
NJ$5.95$6.08
NM$5.95$6.08
NV$5.95$6.08
NY$5.95$6.08
OH$5.95$6.08
OK$5.95$6.08
OR$5.95$6.08
PA$5.95$6.08
PR$6.37—
RI$5.95$6.08
SC$5.95$6.08
SD$5.95$6.08
TN$5.95$6.08
TX$5.95$6.08
UT$5.95$6.08
VA$5.95$6.08
VI$6.08—
VT$5.95$6.08
WA$5.95$6.08
WI$5.95$6.08
WV$5.95$6.08
WY$5.95$6.08

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.53 to $6.86 depending on state and rural status.

StateNon-ruralRural
AK$6.53—
AL—$6.53
AR—$6.53
AZ—$6.53
CA—$6.53
CO—$6.53
CT—$6.53
DC—$6.53
DE—$6.53
FL—$6.53
GA—$6.53
HI$6.53—
IA—$6.53
ID—$6.53
IL—$6.53
IN—$6.53
KS—$6.53
KY—$6.53
LA—$6.53
MA—$6.53
MD—$6.53
ME—$6.53
MI—$6.53
MN—$6.53
MO—$6.53
MS—$6.53
MT—$6.53
NC—$6.53
ND—$6.53
NE—$6.53
NH—$6.53
NJ—$6.53
NM—$6.53
NV—$6.53
NY—$6.53
OH—$6.53
OK—$6.53
OR—$6.53
PA—$6.53
PR$6.86—
RI—$6.53
SC—$6.53
SD—$6.53
TN—$6.53
TX—$6.53
UT—$6.53
VA—$6.53
VI$6.53—
VT—$6.53
WA—$6.53
WI—$6.53
WV—$6.53
WY—$6.53

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.19 to $6.79 depending on state and rural status.

Former-CBA payment limits: ceiling $6.19 · floor $5.26

StateNon-ruralRural
AK$6.19—
AL$6.19—
AR$6.19—
AZ$6.19—
CA$6.19—
CO$6.19—
CT$6.19—
DC$6.19—
DE$6.19—
FL$6.19—
GA$6.19—
HI$6.19—
IA$6.19—
ID$6.19—
IL$6.19—
IN$6.19—
KS$6.19—
KY$6.19—
LA$6.19—
MA$6.19—
MD$6.19—
ME$6.19—
MI$6.19—
MN$6.19—
MO$6.19—
MS$6.19—
MT$6.19—
NC$6.19—
ND$6.19—
NE$6.19—
NH$6.19—
NJ$6.19—
NM$6.19—
NV$6.19—
NY$6.19—
OH$6.19—
OK$6.19—
OR$6.19—
PA$6.19—
PR$6.79—
RI$6.19—
SC$6.19—
SD$6.19—
TN$6.19—
TX$6.19—
UT$6.19—
VA$6.19—
VI$6.19—
VT$6.19—
WA$6.19—
WI$6.19—
WV$6.19—
WY$6.19—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $44.64 to $47.85 depending on state and rural status.

StateNon-ruralRural
AK$45.53—
AL$44.64$45.53
AR$44.64$45.53
AZ$44.64$45.53
CA$44.64$45.53
CO$44.64$45.53
CT$44.64$45.53
DC$44.64$45.53
DE$44.64$45.53
FL$44.64$45.53
GA$44.64$45.53
HI$45.53—
IA$44.64$45.53
ID$44.64$45.53
IL$44.64$45.53
IN$44.64$45.53
KS$44.64$45.53
KY$44.64$45.53
LA$44.64$45.53
MA$44.64$45.53
MD$44.64$45.53
ME$44.64$45.53
MI$44.64$45.53
MN$44.64$45.53
MO$44.64$45.53
MS$44.64$45.53
MT$44.64$45.53
NC$44.64$45.53
ND$44.64$45.53
NE$44.64$45.53
NH$44.64$45.53
NJ$44.64$45.53
NM$44.64$45.53
NV$44.64$45.53
NY$44.64$45.53
OH$44.64$45.53
OK$44.64$45.53
OR$44.64$45.53
PA$44.64$45.53
PR$47.85—
RI$44.64$45.53
SC$44.64$45.53
SD$44.64$45.53
TN$44.64$45.53
TX$44.64$45.53
UT$44.64$45.53
VA$44.64$45.53
VI$45.53—
VT$44.64$45.53
WA$44.64$45.53
WI$44.64$45.53
WV$44.64$45.53
WY$44.64$45.53

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $48.90 to $51.55 depending on state and rural status.

StateNon-ruralRural
AK$48.90—
AL—$48.90
AR—$48.90
AZ—$48.90
CA—$48.90
CO—$48.90
CT—$48.90
DC—$48.90
DE—$48.90
FL—$48.90
GA—$48.90
HI$48.90—
IA—$48.90
ID—$48.90
IL—$48.90
IN—$48.90
KS—$48.90
KY—$48.90
LA—$48.90
MA—$48.90
MD—$48.90
ME—$48.90
MI—$48.90
MN—$48.90
MO—$48.90
MS—$48.90
MT—$48.90
NC—$48.90
ND—$48.90
NE—$48.90
NH—$48.90
NJ—$48.90
NM—$48.90
NV—$48.90
NY—$48.90
OH—$48.90
OK—$48.90
OR—$48.90
PA—$48.90
PR$51.55—
RI—$48.90
SC—$48.90
SD—$48.90
TN—$48.90
TX—$48.90
UT—$48.90
VA—$48.90
VI$48.90—
VT—$48.90
WA—$48.90
WI—$48.90
WV—$48.90
WY—$48.90

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $46.44 to $51.06 depending on state and rural status.

Former-CBA payment limits: ceiling $46.44 · floor $39.47

StateNon-ruralRural
AK$46.44—
AL$46.44—
AR$46.44—
AZ$46.44—
CA$46.44—
CO$46.44—
CT$46.44—
DC$46.44—
DE$46.44—
FL$46.44—
GA$46.44—
HI$46.44—
IA$46.44—
ID$46.44—
IL$46.44—
IN$46.44—
KS$46.44—
KY$46.44—
LA$46.44—
MA$46.44—
MD$46.44—
ME$46.44—
MI$46.44—
MN$46.44—
MO$46.44—
MS$46.44—
MT$46.44—
NC$46.44—
ND$46.44—
NE$46.44—
NH$46.44—
NJ$46.44—
NM$46.44—
NV$46.44—
NY$46.44—
OH$46.44—
OK$46.44—
OR$46.44—
PA$46.44—
PR$51.06—
RI$46.44—
SC$46.44—
SD$46.44—
TN$46.44—
TX$46.44—
UT$46.44—
VA$46.44—
VI$46.44—
VT$46.44—
WA$46.44—
WI$46.44—
WV$46.44—
WY$46.44—
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 E2388 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related E-codes

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