E2614 — Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware
HCPCS Level II E-code · short descriptor: “Position back cush wd>=22in”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Inexpensive or routinely purchased
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
E2614 Medicare fee schedule (April 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $527.46 to $733.82 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $667.01 | — |
| AL | $550.27 | $639.38 |
| AR | $550.27 | $639.38 |
| AZ | $546.92 | $639.38 |
| CA | $527.46 | $639.38 |
| CO | $553.99 | $639.38 |
| CT | $591.03 | $639.38 |
| DC | $536.59 | $639.38 |
| DE | $536.59 | $639.38 |
| FL | $550.27 | $639.38 |
| GA | $550.27 | $639.38 |
| HI | $667.01 | — |
| IA | $542.37 | $639.38 |
| ID | $553.99 | $639.38 |
| IL | $593.54 | $639.38 |
| IN | $593.54 | $639.38 |
| KS | $542.37 | $639.38 |
| KY | $550.27 | $639.38 |
| LA | $550.27 | $639.38 |
| MA | $591.03 | $639.38 |
| MD | $536.59 | $639.38 |
| ME | $591.03 | $639.38 |
| MI | $593.54 | $639.38 |
| MN | $542.37 | $639.38 |
| MO | $542.37 | $639.38 |
| MS | $550.27 | $639.38 |
| MT | $553.99 | $639.38 |
| NC | $550.27 | $639.38 |
| ND | $542.37 | $639.38 |
| NE | $542.37 | $639.38 |
| NH | $591.03 | $639.38 |
| NJ | $536.59 | $639.38 |
| NM | $546.92 | $639.38 |
| NV | $527.46 | $639.38 |
| NY | $536.59 | $639.38 |
| OH | $593.54 | $639.38 |
| OK | $546.92 | $639.38 |
| OR | $527.46 | $639.38 |
| PA | $536.59 | $639.38 |
| PR | $733.82 | — |
| RI | $591.03 | $639.38 |
| SC | $550.27 | $639.38 |
| SD | $542.37 | $639.38 |
| TN | $550.27 | $639.38 |
| TX | $546.92 | $639.38 |
| UT | $553.99 | $639.38 |
| VA | $550.27 | $639.38 |
| VI | $667.01 | — |
| VT | $591.03 | $639.38 |
| WA | $527.46 | $639.38 |
| WI | $593.54 | $639.38 |
| WV | $550.27 | $639.38 |
| WY | $553.99 | $639.38 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $687.82 to $791.95 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $715.45 | — |
| AL | — | $687.82 |
| AR | — | $687.82 |
| AZ | — | $687.82 |
| CA | — | $687.82 |
| CO | — | $687.82 |
| CT | — | $687.82 |
| DC | — | $687.82 |
| DE | — | $687.82 |
| FL | — | $687.82 |
| GA | — | $687.82 |
| HI | $715.45 | — |
| IA | — | $687.82 |
| ID | — | $687.82 |
| IL | — | $687.82 |
| IN | — | $687.82 |
| KS | — | $687.82 |
| KY | — | $687.82 |
| LA | — | $687.82 |
| MA | — | $687.82 |
| MD | — | $687.82 |
| ME | — | $687.82 |
| MI | — | $687.82 |
| MN | — | $687.82 |
| MO | — | $687.82 |
| MS | — | $687.82 |
| MT | — | $687.82 |
| NC | — | $687.82 |
| ND | — | $687.82 |
| NE | — | $687.82 |
| NH | — | $687.82 |
| NJ | — | $687.82 |
| NM | — | $687.82 |
| NV | — | $687.82 |
| NY | — | $687.82 |
| OH | — | $687.82 |
| OK | — | $687.82 |
| OR | — | $687.82 |
| PA | — | $687.82 |
| PR | $791.95 | — |
| RI | — | $687.82 |
| SC | — | $687.82 |
| SD | — | $687.82 |
| TN | — | $687.82 |
| TX | — | $687.82 |
| UT | — | $687.82 |
| VA | — | $687.82 |
| VI | $715.45 | — |
| VT | — | $687.82 |
| WA | — | $687.82 |
| WI | — | $687.82 |
| WV | — | $687.82 |
| WY | — | $687.82 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $668.14 to $801.75 depending on state and rural status.
Former-CBA payment limits: ceiling $668.14 · floor $567.92
| State | Non-rural | Rural |
|---|---|---|
| AK | $668.14 | — |
| AL | $668.14 | — |
| AR | $668.14 | — |
| AZ | $668.14 | — |
| CA | $668.14 | — |
| CO | $668.14 | — |
| CT | $668.14 | — |
| DC | $668.14 | — |
| DE | $668.14 | — |
| FL | $668.14 | — |
| GA | $668.14 | — |
| HI | $668.14 | — |
| IA | $668.14 | — |
| ID | $668.14 | — |
| IL | $668.14 | — |
| IN | $668.14 | — |
| KS | $668.14 | — |
| KY | $668.14 | — |
| LA | $668.14 | — |
| MA | $668.14 | — |
| MD | $668.14 | — |
| ME | $668.14 | — |
| MI | $668.14 | — |
| MN | $668.14 | — |
| MO | $668.14 | — |
| MS | $668.14 | — |
| MT | $668.14 | — |
| NC | $668.14 | — |
| ND | $668.14 | — |
| NE | $668.14 | — |
| NH | $668.14 | — |
| NJ | $668.14 | — |
| NM | $668.14 | — |
| NV | $668.14 | — |
| NY | $668.14 | — |
| OH | $668.14 | — |
| OK | $668.14 | — |
| OR | $668.14 | — |
| PA | $668.14 | — |
| PR | $801.75 | — |
| RI | $668.14 | — |
| SC | $668.14 | — |
| SD | $668.14 | — |
| TN | $668.14 | — |
| TX | $668.14 | — |
| UT | $668.14 | — |
| VA | $668.14 | — |
| VI | $668.14 | — |
| VT | $668.14 | — |
| WA | $668.14 | — |
| WI | $668.14 | — |
| WV | $668.14 | — |
| WY | $668.14 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $52.75 to $73.37 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $66.70 | — |
| AL | $55.03 | $63.94 |
| AR | $55.03 | $63.94 |
| AZ | $54.69 | $63.94 |
| CA | $52.75 | $63.94 |
| CO | $55.40 | $63.94 |
| CT | $59.10 | $63.94 |
| DC | $53.66 | $63.94 |
| DE | $53.66 | $63.94 |
| FL | $55.03 | $63.94 |
| GA | $55.03 | $63.94 |
| HI | $66.70 | — |
| IA | $54.24 | $63.94 |
| ID | $55.40 | $63.94 |
| IL | $59.35 | $63.94 |
| IN | $59.35 | $63.94 |
| KS | $54.24 | $63.94 |
| KY | $55.03 | $63.94 |
| LA | $55.03 | $63.94 |
| MA | $59.10 | $63.94 |
| MD | $53.66 | $63.94 |
| ME | $59.10 | $63.94 |
| MI | $59.35 | $63.94 |
| MN | $54.24 | $63.94 |
| MO | $54.24 | $63.94 |
| MS | $55.03 | $63.94 |
| MT | $55.40 | $63.94 |
| NC | $55.03 | $63.94 |
| ND | $54.24 | $63.94 |
| NE | $54.24 | $63.94 |
| NH | $59.10 | $63.94 |
| NJ | $53.66 | $63.94 |
| NM | $54.69 | $63.94 |
| NV | $52.75 | $63.94 |
| NY | $53.66 | $63.94 |
| OH | $59.35 | $63.94 |
| OK | $54.69 | $63.94 |
| OR | $52.75 | $63.94 |
| PA | $53.66 | $63.94 |
| PR | $73.37 | — |
| RI | $59.10 | $63.94 |
| SC | $55.03 | $63.94 |
| SD | $54.24 | $63.94 |
| TN | $55.03 | $63.94 |
| TX | $54.69 | $63.94 |
| UT | $55.40 | $63.94 |
| VA | $55.03 | $63.94 |
| VI | $66.70 | — |
| VT | $59.10 | $63.94 |
| WA | $52.75 | $63.94 |
| WI | $59.35 | $63.94 |
| WV | $55.03 | $63.94 |
| WY | $55.40 | $63.94 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $68.78 to $79.18 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $71.55 | — |
| AL | — | $68.78 |
| AR | — | $68.78 |
| AZ | — | $68.78 |
| CA | — | $68.78 |
| CO | — | $68.78 |
| CT | — | $68.78 |
| DC | — | $68.78 |
| DE | — | $68.78 |
| FL | — | $68.78 |
| GA | — | $68.78 |
| HI | $71.55 | — |
| IA | — | $68.78 |
| ID | — | $68.78 |
| IL | — | $68.78 |
| IN | — | $68.78 |
| KS | — | $68.78 |
| KY | — | $68.78 |
| LA | — | $68.78 |
| MA | — | $68.78 |
| MD | — | $68.78 |
| ME | — | $68.78 |
| MI | — | $68.78 |
| MN | — | $68.78 |
| MO | — | $68.78 |
| MS | — | $68.78 |
| MT | — | $68.78 |
| NC | — | $68.78 |
| ND | — | $68.78 |
| NE | — | $68.78 |
| NH | — | $68.78 |
| NJ | — | $68.78 |
| NM | — | $68.78 |
| NV | — | $68.78 |
| NY | — | $68.78 |
| OH | — | $68.78 |
| OK | — | $68.78 |
| OR | — | $68.78 |
| PA | — | $68.78 |
| PR | $79.18 | — |
| RI | — | $68.78 |
| SC | — | $68.78 |
| SD | — | $68.78 |
| TN | — | $68.78 |
| TX | — | $68.78 |
| UT | — | $68.78 |
| VA | — | $68.78 |
| VI | $71.55 | — |
| VT | — | $68.78 |
| WA | — | $68.78 |
| WI | — | $68.78 |
| WV | — | $68.78 |
| WY | — | $68.78 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $66.81 to $80.17 depending on state and rural status.
Former-CBA payment limits: ceiling $66.81 · floor $56.79
| State | Non-rural | Rural |
|---|---|---|
| AK | $66.81 | — |
| AL | $66.81 | — |
| AR | $66.81 | — |
| AZ | $66.81 | — |
| CA | $66.81 | — |
| CO | $66.81 | — |
| CT | $66.81 | — |
| DC | $66.81 | — |
| DE | $66.81 | — |
| FL | $66.81 | — |
| GA | $66.81 | — |
| HI | $66.81 | — |
| IA | $66.81 | — |
| ID | $66.81 | — |
| IL | $66.81 | — |
| IN | $66.81 | — |
| KS | $66.81 | — |
| KY | $66.81 | — |
| LA | $66.81 | — |
| MA | $66.81 | — |
| MD | $66.81 | — |
| ME | $66.81 | — |
| MI | $66.81 | — |
| MN | $66.81 | — |
| MO | $66.81 | — |
| MS | $66.81 | — |
| MT | $66.81 | — |
| NC | $66.81 | — |
| ND | $66.81 | — |
| NE | $66.81 | — |
| NH | $66.81 | — |
| NJ | $66.81 | — |
| NM | $66.81 | — |
| NV | $66.81 | — |
| NY | $66.81 | — |
| OH | $66.81 | — |
| OK | $66.81 | — |
| OR | $66.81 | — |
| PA | $66.81 | — |
| PR | $80.17 | — |
| RI | $66.81 | — |
| SC | $66.81 | — |
| SD | $66.81 | — |
| TN | $66.81 | — |
| TX | $66.81 | — |
| UT | $66.81 | — |
| VA | $66.81 | — |
| VI | $66.81 | — |
| VT | $66.81 | — |
| WA | $66.81 | — |
| WI | $66.81 | — |
| WV | $66.81 | — |
| WY | $66.81 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $395.59 to $550.38 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $500.27 | — |
| AL | $412.71 | $479.55 |
| AR | $412.71 | $479.55 |
| AZ | $410.20 | $479.55 |
| CA | $395.59 | $479.55 |
| CO | $415.50 | $479.55 |
| CT | $443.28 | $479.55 |
| DC | $402.45 | $479.55 |
| DE | $402.45 | $479.55 |
| FL | $412.71 | $479.55 |
| GA | $412.71 | $479.55 |
| HI | $500.27 | — |
| IA | $406.77 | $479.55 |
| ID | $415.50 | $479.55 |
| IL | $445.16 | $479.55 |
| IN | $445.16 | $479.55 |
| KS | $406.77 | $479.55 |
| KY | $412.71 | $479.55 |
| LA | $412.71 | $479.55 |
| MA | $443.28 | $479.55 |
| MD | $402.45 | $479.55 |
| ME | $443.28 | $479.55 |
| MI | $445.16 | $479.55 |
| MN | $406.77 | $479.55 |
| MO | $406.77 | $479.55 |
| MS | $412.71 | $479.55 |
| MT | $415.50 | $479.55 |
| NC | $412.71 | $479.55 |
| ND | $406.77 | $479.55 |
| NE | $406.77 | $479.55 |
| NH | $443.28 | $479.55 |
| NJ | $402.45 | $479.55 |
| NM | $410.20 | $479.55 |
| NV | $395.59 | $479.55 |
| NY | $402.45 | $479.55 |
| OH | $445.16 | $479.55 |
| OK | $410.20 | $479.55 |
| OR | $395.59 | $479.55 |
| PA | $402.45 | $479.55 |
| PR | $550.38 | — |
| RI | $443.28 | $479.55 |
| SC | $412.71 | $479.55 |
| SD | $406.77 | $479.55 |
| TN | $412.71 | $479.55 |
| TX | $410.20 | $479.55 |
| UT | $415.50 | $479.55 |
| VA | $412.71 | $479.55 |
| VI | $500.27 | — |
| VT | $443.28 | $479.55 |
| WA | $395.59 | $479.55 |
| WI | $445.16 | $479.55 |
| WV | $412.71 | $479.55 |
| WY | $415.50 | $479.55 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $515.88 to $593.98 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $536.60 | — |
| AL | — | $515.88 |
| AR | — | $515.88 |
| AZ | — | $515.88 |
| CA | — | $515.88 |
| CO | — | $515.88 |
| CT | — | $515.88 |
| DC | — | $515.88 |
| DE | — | $515.88 |
| FL | — | $515.88 |
| GA | — | $515.88 |
| HI | $536.60 | — |
| IA | — | $515.88 |
| ID | — | $515.88 |
| IL | — | $515.88 |
| IN | — | $515.88 |
| KS | — | $515.88 |
| KY | — | $515.88 |
| LA | — | $515.88 |
| MA | — | $515.88 |
| MD | — | $515.88 |
| ME | — | $515.88 |
| MI | — | $515.88 |
| MN | — | $515.88 |
| MO | — | $515.88 |
| MS | — | $515.88 |
| MT | — | $515.88 |
| NC | — | $515.88 |
| ND | — | $515.88 |
| NE | — | $515.88 |
| NH | — | $515.88 |
| NJ | — | $515.88 |
| NM | — | $515.88 |
| NV | — | $515.88 |
| NY | — | $515.88 |
| OH | — | $515.88 |
| OK | — | $515.88 |
| OR | — | $515.88 |
| PA | — | $515.88 |
| PR | $593.98 | — |
| RI | — | $515.88 |
| SC | — | $515.88 |
| SD | — | $515.88 |
| TN | — | $515.88 |
| TX | — | $515.88 |
| UT | — | $515.88 |
| VA | — | $515.88 |
| VI | $536.60 | — |
| VT | — | $515.88 |
| WA | — | $515.88 |
| WI | — | $515.88 |
| WV | — | $515.88 |
| WY | — | $515.88 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $501.13 to $601.35 depending on state and rural status.
Former-CBA payment limits: ceiling $501.13 · floor $425.96
| State | Non-rural | Rural |
|---|---|---|
| AK | $501.13 | — |
| AL | $501.13 | — |
| AR | $501.13 | — |
| AZ | $501.13 | — |
| CA | $501.13 | — |
| CO | $501.13 | — |
| CT | $501.13 | — |
| DC | $501.13 | — |
| DE | $501.13 | — |
| FL | $501.13 | — |
| GA | $501.13 | — |
| HI | $501.13 | — |
| IA | $501.13 | — |
| ID | $501.13 | — |
| IL | $501.13 | — |
| IN | $501.13 | — |
| KS | $501.13 | — |
| KY | $501.13 | — |
| LA | $501.13 | — |
| MA | $501.13 | — |
| MD | $501.13 | — |
| ME | $501.13 | — |
| MI | $501.13 | — |
| MN | $501.13 | — |
| MO | $501.13 | — |
| MS | $501.13 | — |
| MT | $501.13 | — |
| NC | $501.13 | — |
| ND | $501.13 | — |
| NE | $501.13 | — |
| NH | $501.13 | — |
| NJ | $501.13 | — |
| NM | $501.13 | — |
| NV | $501.13 | — |
| NY | $501.13 | — |
| OH | $501.13 | — |
| OK | $501.13 | — |
| OR | $501.13 | — |
| PA | $501.13 | — |
| PR | $601.35 | — |
| RI | $501.13 | — |
| SC | $501.13 | — |
| SD | $501.13 | — |
| TN | $501.13 | — |
| TX | $501.13 | — |
| UT | $501.13 | — |
| VA | $501.13 | — |
| VI | $501.13 | — |
| VT | $501.13 | — |
| WA | $501.13 | — |
| WI | $501.13 | — |
| WV | $501.13 | — |
| WY | $501.13 | — |
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