E2396 — Power wheelchair accessory, caster fork, any size, replacement only, each
HCPCS Level II E-code · short descriptor: “Caster fork”
- 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
- 4
- 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.
E2396 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $61.00 to $139.04 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $132.31 | — |
| AL | $64.29 | $75.90 |
| AR | $64.29 | $75.90 |
| AZ | $61.13 | $75.90 |
| CA | $61.71 | $75.90 |
| CO | $64.64 | $69.44 |
| CT | $69.79 | $75.90 |
| DC | $61.00 | $75.90 |
| DE | $61.00 | $75.90 |
| FL | $64.29 | $69.44 |
| GA | $64.29 | $75.90 |
| HI | $139.04 | — |
| IA | $62.13 | $75.90 |
| ID | $64.64 | $74.13 |
| IL | $63.58 | $75.90 |
| IN | $63.58 | $75.90 |
| KS | $62.13 | $75.90 |
| KY | $64.29 | $69.44 |
| LA | $64.29 | $75.90 |
| MA | $69.79 | $74.41 |
| MD | $61.00 | $69.44 |
| ME | $69.79 | $74.41 |
| MI | $63.58 | $69.44 |
| MN | $62.13 | $74.02 |
| MO | $62.13 | $75.90 |
| MS | $64.29 | $75.90 |
| MT | $64.64 | $69.44 |
| NC | $64.29 | $75.90 |
| ND | $62.13 | $70.41 |
| NE | $62.13 | $75.90 |
| NH | $69.79 | $74.41 |
| NJ | $61.00 | $75.90 |
| NM | $61.13 | $69.44 |
| NV | $61.71 | $69.44 |
| NY | $61.00 | $70.34 |
| OH | $63.58 | $69.44 |
| OK | $61.13 | $75.90 |
| OR | $61.71 | $75.90 |
| PA | $61.00 | $69.44 |
| PR | $89.89 | — |
| RI | $69.79 | $75.90 |
| SC | $64.29 | $74.35 |
| SD | $62.13 | $70.41 |
| TN | $64.29 | $75.90 |
| TX | $61.13 | $69.44 |
| UT | $64.64 | $75.90 |
| VA | $64.29 | $71.65 |
| VI | $70.34 | — |
| VT | $69.79 | $74.41 |
| WA | $61.71 | $75.90 |
| WI | $63.58 | $75.90 |
| WV | $64.29 | $72.98 |
| WY | $64.64 | $70.41 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $74.81 to $154.12 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $146.42 | — |
| AL | — | $81.83 |
| AR | — | $81.83 |
| AZ | — | $81.83 |
| CA | — | $81.83 |
| CO | — | $74.81 |
| CT | — | $81.83 |
| DC | — | $81.83 |
| DE | — | $81.83 |
| FL | — | $74.81 |
| GA | — | $81.83 |
| HI | $154.12 | — |
| IA | — | $81.83 |
| ID | — | $79.80 |
| IL | — | $81.83 |
| IN | — | $81.83 |
| KS | — | $81.83 |
| KY | — | $74.81 |
| LA | — | $81.83 |
| MA | — | $80.11 |
| MD | — | $74.81 |
| ME | — | $80.11 |
| MI | — | $74.81 |
| MN | — | $79.66 |
| MO | — | $81.83 |
| MS | — | $81.83 |
| MT | — | $74.81 |
| NC | — | $81.83 |
| ND | — | $75.54 |
| NE | — | $81.83 |
| NH | — | $80.11 |
| NJ | — | $81.83 |
| NM | — | $74.81 |
| NV | — | $74.81 |
| NY | — | $75.45 |
| OH | — | $74.81 |
| OK | — | $81.83 |
| OR | — | $81.83 |
| PA | — | $74.81 |
| PR | $97.84 | — |
| RI | — | $81.83 |
| SC | — | $80.05 |
| SD | — | $75.54 |
| TN | — | $81.83 |
| TX | — | $74.81 |
| UT | — | $81.83 |
| VA | — | $76.95 |
| VI | $75.45 | — |
| VT | — | $80.11 |
| WA | — | $81.83 |
| WI | — | $81.83 |
| WV | — | $78.48 |
| WY | — | $75.54 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $69.42 to $207.97 depending on state and rural status.
Former-CBA payment limits: ceiling $81.67 · floor $69.42
| State | Non-rural | Rural |
|---|---|---|
| AK | $194.50 | — |
| AL | $81.67 | — |
| AR | $81.67 | — |
| AZ | $81.67 | — |
| CA | $81.67 | — |
| CO | $69.42 | — |
| CT | $81.67 | — |
| DC | $81.67 | — |
| DE | $81.67 | — |
| FL | $69.42 | — |
| GA | $81.67 | — |
| HI | $207.97 | — |
| IA | $81.67 | — |
| ID | $78.16 | — |
| IL | $81.67 | — |
| IN | $81.67 | — |
| KS | $81.67 | — |
| KY | $69.42 | — |
| LA | $81.67 | — |
| MA | $78.70 | — |
| MD | $69.42 | — |
| ME | $78.70 | — |
| MI | $69.42 | — |
| MN | $77.93 | — |
| MO | $81.67 | — |
| MS | $81.67 | — |
| MT | $69.42 | — |
| NC | $81.67 | — |
| ND | $70.71 | — |
| NE | $81.67 | — |
| NH | $78.70 | — |
| NJ | $81.67 | — |
| NM | $69.42 | — |
| NV | $69.42 | — |
| NY | $70.55 | — |
| OH | $69.42 | — |
| OK | $81.67 | — |
| OR | $81.67 | — |
| PA | $69.42 | — |
| PR | $109.67 | — |
| RI | $81.67 | — |
| SC | $78.60 | — |
| SD | $70.71 | — |
| TN | $81.67 | — |
| TX | $69.42 | — |
| UT | $81.67 | — |
| VA | $73.19 | — |
| VI | $70.55 | — |
| VT | $78.70 | — |
| WA | $81.67 | — |
| WI | $81.67 | — |
| WV | $75.83 | — |
| WY | $70.71 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.10 to $13.91 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $13.24 | — |
| AL | $6.43 | $7.88 |
| AR | $6.43 | $7.58 |
| AZ | $6.11 | $7.88 |
| CA | $6.17 | $7.88 |
| CO | $6.46 | $7.22 |
| CT | $6.98 | $7.88 |
| DC | $6.10 | $7.88 |
| DE | $6.10 | $7.88 |
| FL | $6.43 | $7.22 |
| GA | $6.43 | $7.84 |
| HI | $13.91 | — |
| IA | $6.21 | $7.88 |
| ID | $6.46 | $7.42 |
| IL | $6.36 | $7.88 |
| IN | $6.36 | $7.88 |
| KS | $6.21 | $7.88 |
| KY | $6.43 | $7.22 |
| LA | $6.43 | $7.71 |
| MA | $6.98 | $7.88 |
| MD | $6.10 | $7.22 |
| ME | $6.98 | $7.88 |
| MI | $6.36 | $7.22 |
| MN | $6.21 | $7.40 |
| MO | $6.21 | $7.88 |
| MS | $6.43 | $7.88 |
| MT | $6.46 | $7.22 |
| NC | $6.43 | $7.88 |
| ND | $6.21 | $7.22 |
| NE | $6.21 | $7.88 |
| NH | $6.98 | $7.88 |
| NJ | $6.10 | $7.88 |
| NM | $6.11 | $7.22 |
| NV | $6.17 | $7.88 |
| NY | $6.10 | $7.22 |
| OH | $6.36 | $7.22 |
| OK | $6.11 | $7.88 |
| OR | $6.17 | $7.88 |
| PA | $6.10 | $7.22 |
| PR | $10.36 | — |
| RI | $6.98 | $7.88 |
| SC | $6.43 | $7.43 |
| SD | $6.21 | $7.22 |
| TN | $6.43 | $7.88 |
| TX | $6.11 | $7.22 |
| UT | $6.46 | $7.88 |
| VA | $6.43 | $7.22 |
| VI | $7.22 | — |
| VT | $6.98 | $7.88 |
| WA | $6.17 | $7.88 |
| WI | $6.36 | $7.88 |
| WV | $6.43 | $7.31 |
| WY | $6.46 | $7.22 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $7.76 to $15.41 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $14.65 | — |
| AL | — | $8.51 |
| AR | — | $8.17 |
| AZ | — | $8.51 |
| CA | — | $8.51 |
| CO | — | $7.76 |
| CT | — | $8.51 |
| DC | — | $8.51 |
| DE | — | $8.51 |
| FL | — | $7.76 |
| GA | — | $8.47 |
| HI | $15.41 | — |
| IA | — | $8.51 |
| ID | — | $7.98 |
| IL | — | $8.51 |
| IN | — | $8.51 |
| KS | — | $8.51 |
| KY | — | $7.76 |
| LA | — | $8.32 |
| MA | — | $8.51 |
| MD | — | $7.76 |
| ME | — | $8.51 |
| MI | — | $7.76 |
| MN | — | $7.96 |
| MO | — | $8.51 |
| MS | — | $8.51 |
| MT | — | $7.76 |
| NC | — | $8.51 |
| ND | — | $7.76 |
| NE | — | $8.51 |
| NH | — | $8.51 |
| NJ | — | $8.51 |
| NM | — | $7.76 |
| NV | — | $8.51 |
| NY | — | $7.76 |
| OH | — | $7.76 |
| OK | — | $8.51 |
| OR | — | $8.51 |
| PA | — | $7.76 |
| PR | $11.36 | — |
| RI | — | $8.51 |
| SC | — | $8.00 |
| SD | — | $7.76 |
| TN | — | $8.51 |
| TX | — | $7.76 |
| UT | — | $8.51 |
| VA | — | $7.76 |
| VI | $7.76 | — |
| VT | — | $8.51 |
| WA | — | $8.51 |
| WI | — | $8.51 |
| WV | — | $7.86 |
| WY | — | $7.76 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $7.42 to $20.80 depending on state and rural status.
Former-CBA payment limits: ceiling $8.73 · floor $7.42
| State | Non-rural | Rural |
|---|---|---|
| AK | $19.46 | — |
| AL | $8.73 | — |
| AR | $8.15 | — |
| AZ | $8.73 | — |
| CA | $8.73 | — |
| CO | $7.42 | — |
| CT | $8.73 | — |
| DC | $8.73 | — |
| DE | $8.73 | — |
| FL | $7.42 | — |
| GA | $8.66 | — |
| HI | $20.80 | — |
| IA | $8.73 | — |
| ID | $7.82 | — |
| IL | $8.73 | — |
| IN | $8.73 | — |
| KS | $8.73 | — |
| KY | $7.42 | — |
| LA | $8.39 | — |
| MA | $8.73 | — |
| MD | $7.42 | — |
| ME | $8.73 | — |
| MI | $7.42 | — |
| MN | $7.78 | — |
| MO | $8.73 | — |
| MS | $8.73 | — |
| MT | $7.42 | — |
| NC | $8.73 | — |
| ND | $7.42 | — |
| NE | $8.73 | — |
| NH | $8.73 | — |
| NJ | $8.73 | — |
| NM | $7.42 | — |
| NV | $8.73 | — |
| NY | $7.42 | — |
| OH | $7.42 | — |
| OK | $8.73 | — |
| OR | $8.73 | — |
| PA | $7.42 | — |
| PR | $13.70 | — |
| RI | $8.73 | — |
| SC | $7.85 | — |
| SD | $7.42 | — |
| TN | $8.73 | — |
| TX | $7.42 | — |
| UT | $8.73 | — |
| VA | $7.42 | — |
| VI | $7.42 | — |
| VT | $8.73 | — |
| WA | $8.73 | — |
| WI | $8.73 | — |
| WV | $7.61 | — |
| WY | $7.42 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $45.75 to $104.30 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $99.24 | — |
| AL | $48.22 | $56.94 |
| AR | $48.22 | $56.94 |
| AZ | $45.85 | $56.94 |
| CA | $46.29 | $56.94 |
| CO | $48.48 | $52.09 |
| CT | $52.34 | $56.94 |
| DC | $45.75 | $56.94 |
| DE | $45.75 | $56.94 |
| FL | $48.22 | $52.09 |
| GA | $48.22 | $56.94 |
| HI | $104.30 | — |
| IA | $46.60 | $56.94 |
| ID | $48.48 | $55.60 |
| IL | $47.69 | $56.94 |
| IN | $47.69 | $56.94 |
| KS | $46.60 | $56.94 |
| KY | $48.22 | $52.09 |
| LA | $48.22 | $56.94 |
| MA | $52.34 | $55.82 |
| MD | $45.75 | $52.09 |
| ME | $52.34 | $55.82 |
| MI | $47.69 | $52.09 |
| MN | $46.60 | $55.52 |
| MO | $46.60 | $56.94 |
| MS | $48.22 | $56.94 |
| MT | $48.48 | $52.09 |
| NC | $48.22 | $56.94 |
| ND | $46.60 | $52.80 |
| NE | $46.60 | $56.94 |
| NH | $52.34 | $55.82 |
| NJ | $45.75 | $56.94 |
| NM | $45.85 | $52.09 |
| NV | $46.29 | $52.09 |
| NY | $45.75 | $52.74 |
| OH | $47.69 | $52.09 |
| OK | $45.85 | $56.94 |
| OR | $46.29 | $56.94 |
| PA | $45.75 | $52.09 |
| PR | $67.42 | — |
| RI | $52.34 | $56.94 |
| SC | $48.22 | $55.77 |
| SD | $46.60 | $52.80 |
| TN | $48.22 | $56.94 |
| TX | $45.85 | $52.09 |
| UT | $48.48 | $56.94 |
| VA | $48.22 | $53.74 |
| VI | $52.74 | — |
| VT | $52.34 | $55.82 |
| WA | $46.29 | $56.94 |
| WI | $47.69 | $56.94 |
| WV | $48.22 | $54.76 |
| WY | $48.48 | $52.80 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $56.12 to $115.61 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $109.82 | — |
| AL | — | $61.38 |
| AR | — | $61.38 |
| AZ | — | $61.38 |
| CA | — | $61.38 |
| CO | — | $56.12 |
| CT | — | $61.38 |
| DC | — | $61.38 |
| DE | — | $61.38 |
| FL | — | $56.12 |
| GA | — | $61.38 |
| HI | $115.61 | — |
| IA | — | $61.38 |
| ID | — | $59.85 |
| IL | — | $61.38 |
| IN | — | $61.38 |
| KS | — | $61.38 |
| KY | — | $56.12 |
| LA | — | $61.38 |
| MA | — | $60.10 |
| MD | — | $56.12 |
| ME | — | $60.10 |
| MI | — | $56.12 |
| MN | — | $59.76 |
| MO | — | $61.38 |
| MS | — | $61.38 |
| MT | — | $56.12 |
| NC | — | $61.38 |
| ND | — | $56.65 |
| NE | — | $61.38 |
| NH | — | $60.10 |
| NJ | — | $61.38 |
| NM | — | $56.12 |
| NV | — | $56.12 |
| NY | — | $56.57 |
| OH | — | $56.12 |
| OK | — | $61.38 |
| OR | — | $61.38 |
| PA | — | $56.12 |
| PR | $73.39 | — |
| RI | — | $61.38 |
| SC | — | $60.04 |
| SD | — | $56.65 |
| TN | — | $61.38 |
| TX | — | $56.12 |
| UT | — | $61.38 |
| VA | — | $57.72 |
| VI | $56.57 | — |
| VT | — | $60.10 |
| WA | — | $61.38 |
| WI | — | $61.38 |
| WV | — | $58.88 |
| WY | — | $56.65 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $52.10 to $155.99 depending on state and rural status.
Former-CBA payment limits: ceiling $61.29 · floor $52.10
| State | Non-rural | Rural |
|---|---|---|
| AK | $145.89 | — |
| AL | $61.29 | — |
| AR | $61.29 | — |
| AZ | $61.29 | — |
| CA | $61.29 | — |
| CO | $52.10 | — |
| CT | $61.29 | — |
| DC | $61.29 | — |
| DE | $61.29 | — |
| FL | $52.10 | — |
| GA | $61.29 | — |
| HI | $155.99 | — |
| IA | $61.29 | — |
| ID | $58.62 | — |
| IL | $61.29 | — |
| IN | $61.29 | — |
| KS | $61.29 | — |
| KY | $52.10 | — |
| LA | $61.29 | — |
| MA | $59.06 | — |
| MD | $52.10 | — |
| ME | $59.06 | — |
| MI | $52.10 | — |
| MN | $58.44 | — |
| MO | $61.29 | — |
| MS | $61.29 | — |
| MT | $52.10 | — |
| NC | $61.29 | — |
| ND | $53.03 | — |
| NE | $61.29 | — |
| NH | $59.06 | — |
| NJ | $61.29 | — |
| NM | $52.10 | — |
| NV | $52.10 | — |
| NY | $52.89 | — |
| OH | $52.10 | — |
| OK | $61.29 | — |
| OR | $61.29 | — |
| PA | $52.10 | — |
| PR | $82.25 | — |
| RI | $61.29 | — |
| SC | $58.96 | — |
| SD | $53.03 | — |
| TN | $61.29 | — |
| TX | $52.10 | — |
| UT | $61.29 | — |
| VA | $54.90 | — |
| VI | $52.89 | — |
| VT | $59.06 | — |
| WA | $61.29 | — |
| WI | $61.29 | — |
| WV | $56.91 | — |
| WY | $53.03 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2396 at 4 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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