E2394 — Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each
HCPCS Level II E-code · short descriptor: “Drive wheel excludes 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.
E2394 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $68.29 to $103.29 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $93.89 | — |
| AL | $71.04 | $86.08 |
| AR | $71.04 | $86.08 |
| AZ | $70.19 | $86.08 |
| CA | $68.29 | $86.08 |
| CO | $69.61 | $86.08 |
| CT | $71.78 | $86.08 |
| DC | $69.60 | $86.08 |
| DE | $69.60 | $86.08 |
| FL | $71.04 | $86.08 |
| GA | $71.04 | $86.08 |
| HI | $93.89 | — |
| IA | $71.08 | $86.08 |
| ID | $69.61 | $86.08 |
| IL | $73.69 | $86.08 |
| IN | $73.69 | $86.08 |
| KS | $71.08 | $86.08 |
| KY | $71.04 | $86.08 |
| LA | $71.04 | $86.08 |
| MA | $71.78 | $86.08 |
| MD | $69.60 | $86.08 |
| ME | $71.78 | $86.08 |
| MI | $73.69 | $86.08 |
| MN | $71.08 | $86.08 |
| MO | $71.08 | $86.08 |
| MS | $71.04 | $86.08 |
| MT | $69.61 | $86.08 |
| NC | $71.04 | $86.08 |
| ND | $71.08 | $86.08 |
| NE | $71.08 | $86.08 |
| NH | $71.78 | $86.08 |
| NJ | $69.60 | $86.08 |
| NM | $70.19 | $86.08 |
| NV | $68.29 | $86.08 |
| NY | $69.60 | $86.08 |
| OH | $73.69 | $86.08 |
| OK | $70.19 | $86.08 |
| OR | $68.29 | $86.08 |
| PA | $69.60 | $86.08 |
| PR | $103.29 | — |
| RI | $71.78 | $86.08 |
| SC | $71.04 | $86.08 |
| SD | $71.08 | $86.08 |
| TN | $71.04 | $86.08 |
| TX | $70.19 | $86.08 |
| UT | $69.61 | $86.08 |
| VA | $71.04 | $86.08 |
| VI | $93.89 | — |
| VT | $71.78 | $86.08 |
| WA | $68.29 | $86.08 |
| WI | $73.69 | $86.08 |
| WV | $71.04 | $86.08 |
| WY | $69.61 | $86.08 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $92.92 to $111.49 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $100.72 | — |
| AL | — | $92.92 |
| AR | — | $92.92 |
| AZ | — | $92.92 |
| CA | — | $92.92 |
| CO | — | $92.92 |
| CT | — | $92.92 |
| DC | — | $92.92 |
| DE | — | $92.92 |
| FL | — | $92.92 |
| GA | — | $92.92 |
| HI | $100.72 | — |
| IA | — | $92.92 |
| ID | — | $92.92 |
| IL | — | $92.92 |
| IN | — | $92.92 |
| KS | — | $92.92 |
| KY | — | $92.92 |
| LA | — | $92.92 |
| MA | — | $92.92 |
| MD | — | $92.92 |
| ME | — | $92.92 |
| MI | — | $92.92 |
| MN | — | $92.92 |
| MO | — | $92.92 |
| MS | — | $92.92 |
| MT | — | $92.92 |
| NC | — | $92.92 |
| ND | — | $92.92 |
| NE | — | $92.92 |
| NH | — | $92.92 |
| NJ | — | $92.92 |
| NM | — | $92.92 |
| NV | — | $92.92 |
| NY | — | $92.92 |
| OH | — | $92.92 |
| OK | — | $92.92 |
| OR | — | $92.92 |
| PA | — | $92.92 |
| PR | $111.49 | — |
| RI | — | $92.92 |
| SC | — | $92.92 |
| SD | — | $92.92 |
| TN | — | $92.92 |
| TX | — | $92.92 |
| UT | — | $92.92 |
| VA | — | $92.92 |
| VI | $100.72 | — |
| VT | — | $92.92 |
| WA | — | $92.92 |
| WI | — | $92.92 |
| WV | — | $92.92 |
| WY | — | $92.92 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $94.30 to $113.09 depending on state and rural status.
Former-CBA payment limits: ceiling $94.30 · floor $80.16
| State | Non-rural | Rural |
|---|---|---|
| AK | $94.30 | — |
| AL | $94.30 | — |
| AR | $94.30 | — |
| AZ | $94.30 | — |
| CA | $94.30 | — |
| CO | $94.30 | — |
| CT | $94.30 | — |
| DC | $94.30 | — |
| DE | $94.30 | — |
| FL | $94.30 | — |
| GA | $94.30 | — |
| HI | $94.30 | — |
| IA | $94.30 | — |
| ID | $94.30 | — |
| IL | $94.30 | — |
| IN | $94.30 | — |
| KS | $94.30 | — |
| KY | $94.30 | — |
| LA | $94.30 | — |
| MA | $94.30 | — |
| MD | $94.30 | — |
| ME | $94.30 | — |
| MI | $94.30 | — |
| MN | $94.30 | — |
| MO | $94.30 | — |
| MS | $94.30 | — |
| MT | $94.30 | — |
| NC | $94.30 | — |
| ND | $94.30 | — |
| NE | $94.30 | — |
| NH | $94.30 | — |
| NJ | $94.30 | — |
| NM | $94.30 | — |
| NV | $94.30 | — |
| NY | $94.30 | — |
| OH | $94.30 | — |
| OK | $94.30 | — |
| OR | $94.30 | — |
| PA | $94.30 | — |
| PR | $113.09 | — |
| RI | $94.30 | — |
| SC | $94.30 | — |
| SD | $94.30 | — |
| TN | $94.30 | — |
| TX | $94.30 | — |
| UT | $94.30 | — |
| VA | $94.30 | — |
| VI | $94.30 | — |
| VT | $94.30 | — |
| WA | $94.30 | — |
| WI | $94.30 | — |
| WV | $94.30 | — |
| WY | $94.30 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.83 to $10.34 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $9.40 | — |
| AL | $7.10 | $8.62 |
| AR | $7.10 | $8.62 |
| AZ | $7.02 | $8.62 |
| CA | $6.83 | $8.62 |
| CO | $6.96 | $8.62 |
| CT | $7.18 | $8.62 |
| DC | $6.96 | $8.62 |
| DE | $6.96 | $8.62 |
| FL | $7.10 | $8.62 |
| GA | $7.10 | $8.62 |
| HI | $9.40 | — |
| IA | $7.11 | $8.62 |
| ID | $6.96 | $8.62 |
| IL | $7.37 | $8.62 |
| IN | $7.37 | $8.62 |
| KS | $7.11 | $8.62 |
| KY | $7.10 | $8.62 |
| LA | $7.10 | $8.62 |
| MA | $7.18 | $8.62 |
| MD | $6.96 | $8.62 |
| ME | $7.18 | $8.62 |
| MI | $7.37 | $8.62 |
| MN | $7.11 | $8.62 |
| MO | $7.11 | $8.62 |
| MS | $7.10 | $8.62 |
| MT | $6.96 | $8.62 |
| NC | $7.10 | $8.62 |
| ND | $7.11 | $8.62 |
| NE | $7.11 | $8.62 |
| NH | $7.18 | $8.62 |
| NJ | $6.96 | $8.62 |
| NM | $7.02 | $8.62 |
| NV | $6.83 | $8.62 |
| NY | $6.96 | $8.62 |
| OH | $7.37 | $8.62 |
| OK | $7.02 | $8.62 |
| OR | $6.83 | $8.62 |
| PA | $6.96 | $8.62 |
| PR | $10.34 | — |
| RI | $7.18 | $8.62 |
| SC | $7.10 | $8.62 |
| SD | $7.11 | $8.62 |
| TN | $7.10 | $8.62 |
| TX | $7.02 | $8.62 |
| UT | $6.96 | $8.62 |
| VA | $7.10 | $8.62 |
| VI | $9.40 | — |
| VT | $7.18 | $8.62 |
| WA | $6.83 | $8.62 |
| WI | $7.37 | $8.62 |
| WV | $7.10 | $8.62 |
| WY | $6.96 | $8.62 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $9.30 to $11.16 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $10.08 | — |
| AL | — | $9.30 |
| AR | — | $9.30 |
| AZ | — | $9.30 |
| CA | — | $9.30 |
| CO | — | $9.30 |
| CT | — | $9.30 |
| DC | — | $9.30 |
| DE | — | $9.30 |
| FL | — | $9.30 |
| GA | — | $9.30 |
| HI | $10.08 | — |
| IA | — | $9.30 |
| ID | — | $9.30 |
| IL | — | $9.30 |
| IN | — | $9.30 |
| KS | — | $9.30 |
| KY | — | $9.30 |
| LA | — | $9.30 |
| MA | — | $9.30 |
| MD | — | $9.30 |
| ME | — | $9.30 |
| MI | — | $9.30 |
| MN | — | $9.30 |
| MO | — | $9.30 |
| MS | — | $9.30 |
| MT | — | $9.30 |
| NC | — | $9.30 |
| ND | — | $9.30 |
| NE | — | $9.30 |
| NH | — | $9.30 |
| NJ | — | $9.30 |
| NM | — | $9.30 |
| NV | — | $9.30 |
| NY | — | $9.30 |
| OH | — | $9.30 |
| OK | — | $9.30 |
| OR | — | $9.30 |
| PA | — | $9.30 |
| PR | $11.16 | — |
| RI | — | $9.30 |
| SC | — | $9.30 |
| SD | — | $9.30 |
| TN | — | $9.30 |
| TX | — | $9.30 |
| UT | — | $9.30 |
| VA | — | $9.30 |
| VI | $10.08 | — |
| VT | — | $9.30 |
| WA | — | $9.30 |
| WI | — | $9.30 |
| WV | — | $9.30 |
| WY | — | $9.30 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $9.46 to $11.32 depending on state and rural status.
Former-CBA payment limits: ceiling $9.46 · floor $8.04
| State | Non-rural | Rural |
|---|---|---|
| AK | $9.46 | — |
| AL | $9.46 | — |
| AR | $9.46 | — |
| AZ | $9.46 | — |
| CA | $9.46 | — |
| CO | $9.46 | — |
| CT | $9.46 | — |
| DC | $9.46 | — |
| DE | $9.46 | — |
| FL | $9.46 | — |
| GA | $9.46 | — |
| HI | $9.46 | — |
| IA | $9.46 | — |
| ID | $9.46 | — |
| IL | $9.46 | — |
| IN | $9.46 | — |
| KS | $9.46 | — |
| KY | $9.46 | — |
| LA | $9.46 | — |
| MA | $9.46 | — |
| MD | $9.46 | — |
| ME | $9.46 | — |
| MI | $9.46 | — |
| MN | $9.46 | — |
| MO | $9.46 | — |
| MS | $9.46 | — |
| MT | $9.46 | — |
| NC | $9.46 | — |
| ND | $9.46 | — |
| NE | $9.46 | — |
| NH | $9.46 | — |
| NJ | $9.46 | — |
| NM | $9.46 | — |
| NV | $9.46 | — |
| NY | $9.46 | — |
| OH | $9.46 | — |
| OK | $9.46 | — |
| OR | $9.46 | — |
| PA | $9.46 | — |
| PR | $11.32 | — |
| RI | $9.46 | — |
| SC | $9.46 | — |
| SD | $9.46 | — |
| TN | $9.46 | — |
| TX | $9.46 | — |
| UT | $9.46 | — |
| VA | $9.46 | — |
| VI | $9.46 | — |
| VT | $9.46 | — |
| WA | $9.46 | — |
| WI | $9.46 | — |
| WV | $9.46 | — |
| WY | $9.46 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $51.21 to $77.48 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $70.42 | — |
| AL | $53.28 | $64.56 |
| AR | $53.28 | $64.56 |
| AZ | $52.65 | $64.56 |
| CA | $51.21 | $64.56 |
| CO | $52.21 | $64.56 |
| CT | $53.83 | $64.56 |
| DC | $52.21 | $64.56 |
| DE | $52.21 | $64.56 |
| FL | $53.28 | $64.56 |
| GA | $53.28 | $64.56 |
| HI | $70.42 | — |
| IA | $53.31 | $64.56 |
| ID | $52.21 | $64.56 |
| IL | $55.27 | $64.56 |
| IN | $55.27 | $64.56 |
| KS | $53.31 | $64.56 |
| KY | $53.28 | $64.56 |
| LA | $53.28 | $64.56 |
| MA | $53.83 | $64.56 |
| MD | $52.21 | $64.56 |
| ME | $53.83 | $64.56 |
| MI | $55.27 | $64.56 |
| MN | $53.31 | $64.56 |
| MO | $53.31 | $64.56 |
| MS | $53.28 | $64.56 |
| MT | $52.21 | $64.56 |
| NC | $53.28 | $64.56 |
| ND | $53.31 | $64.56 |
| NE | $53.31 | $64.56 |
| NH | $53.83 | $64.56 |
| NJ | $52.21 | $64.56 |
| NM | $52.65 | $64.56 |
| NV | $51.21 | $64.56 |
| NY | $52.21 | $64.56 |
| OH | $55.27 | $64.56 |
| OK | $52.65 | $64.56 |
| OR | $51.21 | $64.56 |
| PA | $52.21 | $64.56 |
| PR | $77.48 | — |
| RI | $53.83 | $64.56 |
| SC | $53.28 | $64.56 |
| SD | $53.31 | $64.56 |
| TN | $53.28 | $64.56 |
| TX | $52.65 | $64.56 |
| UT | $52.21 | $64.56 |
| VA | $53.28 | $64.56 |
| VI | $70.42 | — |
| VT | $53.83 | $64.56 |
| WA | $51.21 | $64.56 |
| WI | $55.27 | $64.56 |
| WV | $53.28 | $64.56 |
| WY | $52.21 | $64.56 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $69.69 to $83.64 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $75.54 | — |
| AL | — | $69.69 |
| AR | — | $69.69 |
| AZ | — | $69.69 |
| CA | — | $69.69 |
| CO | — | $69.69 |
| CT | — | $69.69 |
| DC | — | $69.69 |
| DE | — | $69.69 |
| FL | — | $69.69 |
| GA | — | $69.69 |
| HI | $75.54 | — |
| IA | — | $69.69 |
| ID | — | $69.69 |
| IL | — | $69.69 |
| IN | — | $69.69 |
| KS | — | $69.69 |
| KY | — | $69.69 |
| LA | — | $69.69 |
| MA | — | $69.69 |
| MD | — | $69.69 |
| ME | — | $69.69 |
| MI | — | $69.69 |
| MN | — | $69.69 |
| MO | — | $69.69 |
| MS | — | $69.69 |
| MT | — | $69.69 |
| NC | — | $69.69 |
| ND | — | $69.69 |
| NE | — | $69.69 |
| NH | — | $69.69 |
| NJ | — | $69.69 |
| NM | — | $69.69 |
| NV | — | $69.69 |
| NY | — | $69.69 |
| OH | — | $69.69 |
| OK | — | $69.69 |
| OR | — | $69.69 |
| PA | — | $69.69 |
| PR | $83.64 | — |
| RI | — | $69.69 |
| SC | — | $69.69 |
| SD | — | $69.69 |
| TN | — | $69.69 |
| TX | — | $69.69 |
| UT | — | $69.69 |
| VA | — | $69.69 |
| VI | $75.54 | — |
| VT | — | $69.69 |
| WA | — | $69.69 |
| WI | — | $69.69 |
| WV | — | $69.69 |
| WY | — | $69.69 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $70.73 to $84.87 depending on state and rural status.
Former-CBA payment limits: ceiling $70.73 · floor $60.12
| State | Non-rural | Rural |
|---|---|---|
| AK | $70.73 | — |
| AL | $70.73 | — |
| AR | $70.73 | — |
| AZ | $70.73 | — |
| CA | $70.73 | — |
| CO | $70.73 | — |
| CT | $70.73 | — |
| DC | $70.73 | — |
| DE | $70.73 | — |
| FL | $70.73 | — |
| GA | $70.73 | — |
| HI | $70.73 | — |
| IA | $70.73 | — |
| ID | $70.73 | — |
| IL | $70.73 | — |
| IN | $70.73 | — |
| KS | $70.73 | — |
| KY | $70.73 | — |
| LA | $70.73 | — |
| MA | $70.73 | — |
| MD | $70.73 | — |
| ME | $70.73 | — |
| MI | $70.73 | — |
| MN | $70.73 | — |
| MO | $70.73 | — |
| MS | $70.73 | — |
| MT | $70.73 | — |
| NC | $70.73 | — |
| ND | $70.73 | — |
| NE | $70.73 | — |
| NH | $70.73 | — |
| NJ | $70.73 | — |
| NM | $70.73 | — |
| NV | $70.73 | — |
| NY | $70.73 | — |
| OH | $70.73 | — |
| OK | $70.73 | — |
| OR | $70.73 | — |
| PA | $70.73 | — |
| PR | $84.87 | — |
| RI | $70.73 | — |
| SC | $70.73 | — |
| SD | $70.73 | — |
| TN | $70.73 | — |
| TX | $70.73 | — |
| UT | $70.73 | — |
| VA | $70.73 | — |
| VI | $70.73 | — |
| VT | $70.73 | — |
| WA | $70.73 | — |
| WI | $70.73 | — |
| WV | $70.73 | — |
| WY | $70.73 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2394 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
Related E-codes
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