MyMedi-AI

E2615 — Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware

HCPCS Level II E-code · short descriptor: “Pos back post/lat wdth <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
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
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.

E2615 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $414.63 to $569.42 depending on state and rural status.

StateNon-ruralRural
AK$513.83—
AL$432.88$513.83
AR$432.88$513.83
AZ$424.17$513.83
CA$414.63$513.83
CO$431.13$513.83
CT$433.20$513.83
DC$417.41$513.83
DE$417.41$513.83
FL$432.88$513.83
GA$432.88$513.83
HI$513.83—
IA$435.73$513.83
ID$431.13$513.83
IL$434.04$513.83
IN$434.04$513.83
KS$435.73$513.83
KY$432.88$513.83
LA$432.88$513.83
MA$433.20$513.83
MD$417.41$513.83
ME$433.20$513.83
MI$434.04$513.83
MN$435.73$513.83
MO$435.73$513.83
MS$432.88$513.83
MT$431.13$513.83
NC$432.88$513.83
ND$435.73$513.83
NE$435.73$513.83
NH$433.20$513.83
NJ$417.41$513.83
NM$424.17$513.83
NV$414.63$513.83
NY$417.41$513.83
OH$434.04$513.83
OK$424.17$513.83
OR$414.63$513.83
PA$417.41$513.83
PR$569.42—
RI$433.20$513.83
SC$432.88$513.83
SD$435.73$513.83
TN$432.88$513.83
TX$424.17$513.83
UT$431.13$513.83
VA$432.88$513.83
VI$513.83—
VT$433.20$513.83
WA$414.63$513.83
WI$434.04$513.83
WV$432.88$513.83
WY$431.13$513.83

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $554.11 to $617.76 depending on state and rural status.

StateNon-ruralRural
AK$554.11—
AL—$554.11
AR—$554.11
AZ—$554.11
CA—$554.11
CO—$554.11
CT—$554.11
DC—$554.11
DE—$554.11
FL—$554.11
GA—$554.11
HI$554.11—
IA—$554.11
ID—$554.11
IL—$554.11
IN—$554.11
KS—$554.11
KY—$554.11
LA—$554.11
MA—$554.11
MD—$554.11
ME—$554.11
MI—$554.11
MN—$554.11
MO—$554.11
MS—$554.11
MT—$554.11
NC—$554.11
ND—$554.11
NE—$554.11
NH—$554.11
NJ—$554.11
NM—$554.11
NV—$554.11
NY—$554.11
OH—$554.11
OK—$554.11
OR—$554.11
PA—$554.11
PR$617.76—
RI—$554.11
SC—$554.11
SD—$554.11
TN—$554.11
TX—$554.11
UT—$554.11
VA—$554.11
VI$554.11—
VT—$554.11
WA—$554.11
WI—$554.11
WV—$554.11
WY—$554.11

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $555.58 to $666.76 depending on state and rural status.

Former-CBA payment limits: ceiling $555.58 · floor $472.24

StateNon-ruralRural
AK$555.58—
AL$555.58—
AR$555.58—
AZ$555.58—
CA$555.58—
CO$555.58—
CT$555.58—
DC$555.58—
DE$555.58—
FL$555.58—
GA$555.58—
HI$555.58—
IA$555.58—
ID$555.58—
IL$555.58—
IN$555.58—
KS$555.58—
KY$555.58—
LA$555.58—
MA$555.58—
MD$555.58—
ME$555.58—
MI$555.58—
MN$555.58—
MO$555.58—
MS$555.58—
MT$555.58—
NC$555.58—
ND$555.58—
NE$555.58—
NH$555.58—
NJ$555.58—
NM$555.58—
NV$555.58—
NY$555.58—
OH$555.58—
OK$555.58—
OR$555.58—
PA$555.58—
PR$666.76—
RI$555.58—
SC$555.58—
SD$555.58—
TN$555.58—
TX$555.58—
UT$555.58—
VA$555.58—
VI$555.58—
VT$555.58—
WA$555.58—
WI$555.58—
WV$555.58—
WY$555.58—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $41.46 to $56.94 depending on state and rural status.

StateNon-ruralRural
AK$51.39—
AL$43.29$51.39
AR$43.29$51.39
AZ$42.42$51.39
CA$41.46$51.39
CO$43.11$51.39
CT$43.32$51.39
DC$41.74$51.39
DE$41.74$51.39
FL$43.29$51.39
GA$43.29$51.39
HI$51.39—
IA$43.57$51.39
ID$43.11$51.39
IL$43.40$51.39
IN$43.40$51.39
KS$43.57$51.39
KY$43.29$51.39
LA$43.29$51.39
MA$43.32$51.39
MD$41.74$51.39
ME$43.32$51.39
MI$43.40$51.39
MN$43.57$51.39
MO$43.57$51.39
MS$43.29$51.39
MT$43.11$51.39
NC$43.29$51.39
ND$43.57$51.39
NE$43.57$51.39
NH$43.32$51.39
NJ$41.74$51.39
NM$42.42$51.39
NV$41.46$51.39
NY$41.74$51.39
OH$43.40$51.39
OK$42.42$51.39
OR$41.46$51.39
PA$41.74$51.39
PR$56.94—
RI$43.32$51.39
SC$43.29$51.39
SD$43.57$51.39
TN$43.29$51.39
TX$42.42$51.39
UT$43.11$51.39
VA$43.29$51.39
VI$51.39—
VT$43.32$51.39
WA$41.46$51.39
WI$43.40$51.39
WV$43.29$51.39
WY$43.11$51.39

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $55.42 to $61.78 depending on state and rural status.

StateNon-ruralRural
AK$55.42—
AL—$55.42
AR—$55.42
AZ—$55.42
CA—$55.42
CO—$55.42
CT—$55.42
DC—$55.42
DE—$55.42
FL—$55.42
GA—$55.42
HI$55.42—
IA—$55.42
ID—$55.42
IL—$55.42
IN—$55.42
KS—$55.42
KY—$55.42
LA—$55.42
MA—$55.42
MD—$55.42
ME—$55.42
MI—$55.42
MN—$55.42
MO—$55.42
MS—$55.42
MT—$55.42
NC—$55.42
ND—$55.42
NE—$55.42
NH—$55.42
NJ—$55.42
NM—$55.42
NV—$55.42
NY—$55.42
OH—$55.42
OK—$55.42
OR—$55.42
PA—$55.42
PR$61.78—
RI—$55.42
SC—$55.42
SD—$55.42
TN—$55.42
TX—$55.42
UT—$55.42
VA—$55.42
VI$55.42—
VT—$55.42
WA—$55.42
WI—$55.42
WV—$55.42
WY—$55.42

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $55.57 to $66.67 depending on state and rural status.

Former-CBA payment limits: ceiling $55.57 · floor $47.23

StateNon-ruralRural
AK$55.57—
AL$55.57—
AR$55.57—
AZ$55.57—
CA$55.57—
CO$55.57—
CT$55.57—
DC$55.57—
DE$55.57—
FL$55.57—
GA$55.57—
HI$55.57—
IA$55.57—
ID$55.57—
IL$55.57—
IN$55.57—
KS$55.57—
KY$55.57—
LA$55.57—
MA$55.57—
MD$55.57—
ME$55.57—
MI$55.57—
MN$55.57—
MO$55.57—
MS$55.57—
MT$55.57—
NC$55.57—
ND$55.57—
NE$55.57—
NH$55.57—
NJ$55.57—
NM$55.57—
NV$55.57—
NY$55.57—
OH$55.57—
OK$55.57—
OR$55.57—
PA$55.57—
PR$66.67—
RI$55.57—
SC$55.57—
SD$55.57—
TN$55.57—
TX$55.57—
UT$55.57—
VA$55.57—
VI$55.57—
VT$55.57—
WA$55.57—
WI$55.57—
WV$55.57—
WY$55.57—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $310.97 to $427.06 depending on state and rural status.

StateNon-ruralRural
AK$385.38—
AL$324.66$385.38
AR$324.66$385.38
AZ$318.13$385.38
CA$310.97$385.38
CO$323.35$385.38
CT$324.91$385.38
DC$313.06$385.38
DE$313.06$385.38
FL$324.66$385.38
GA$324.66$385.38
HI$385.38—
IA$326.80$385.38
ID$323.35$385.38
IL$325.53$385.38
IN$325.53$385.38
KS$326.80$385.38
KY$324.66$385.38
LA$324.66$385.38
MA$324.91$385.38
MD$313.06$385.38
ME$324.91$385.38
MI$325.53$385.38
MN$326.80$385.38
MO$326.80$385.38
MS$324.66$385.38
MT$323.35$385.38
NC$324.66$385.38
ND$326.80$385.38
NE$326.80$385.38
NH$324.91$385.38
NJ$313.06$385.38
NM$318.13$385.38
NV$310.97$385.38
NY$313.06$385.38
OH$325.53$385.38
OK$318.13$385.38
OR$310.97$385.38
PA$313.06$385.38
PR$427.06—
RI$324.91$385.38
SC$324.66$385.38
SD$326.80$385.38
TN$324.66$385.38
TX$318.13$385.38
UT$323.35$385.38
VA$324.66$385.38
VI$385.38—
VT$324.91$385.38
WA$310.97$385.38
WI$325.53$385.38
WV$324.66$385.38
WY$323.35$385.38

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $415.59 to $463.31 depending on state and rural status.

StateNon-ruralRural
AK$415.59—
AL—$415.59
AR—$415.59
AZ—$415.59
CA—$415.59
CO—$415.59
CT—$415.59
DC—$415.59
DE—$415.59
FL—$415.59
GA—$415.59
HI$415.59—
IA—$415.59
ID—$415.59
IL—$415.59
IN—$415.59
KS—$415.59
KY—$415.59
LA—$415.59
MA—$415.59
MD—$415.59
ME—$415.59
MI—$415.59
MN—$415.59
MO—$415.59
MS—$415.59
MT—$415.59
NC—$415.59
ND—$415.59
NE—$415.59
NH—$415.59
NJ—$415.59
NM—$415.59
NV—$415.59
NY—$415.59
OH—$415.59
OK—$415.59
OR—$415.59
PA—$415.59
PR$463.31—
RI—$415.59
SC—$415.59
SD—$415.59
TN—$415.59
TX—$415.59
UT—$415.59
VA—$415.59
VI$415.59—
VT—$415.59
WA—$415.59
WI—$415.59
WV—$415.59
WY—$415.59

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $416.68 to $500.07 depending on state and rural status.

Former-CBA payment limits: ceiling $416.68 · floor $354.18

StateNon-ruralRural
AK$416.68—
AL$416.68—
AR$416.68—
AZ$416.68—
CA$416.68—
CO$416.68—
CT$416.68—
DC$416.68—
DE$416.68—
FL$416.68—
GA$416.68—
HI$416.68—
IA$416.68—
ID$416.68—
IL$416.68—
IN$416.68—
KS$416.68—
KY$416.68—
LA$416.68—
MA$416.68—
MD$416.68—
ME$416.68—
MI$416.68—
MN$416.68—
MO$416.68—
MS$416.68—
MT$416.68—
NC$416.68—
ND$416.68—
NE$416.68—
NH$416.68—
NJ$416.68—
NM$416.68—
NV$416.68—
NY$416.68—
OH$416.68—
OK$416.68—
OR$416.68—
PA$416.68—
PR$500.07—
RI$416.68—
SC$416.68—
SD$416.68—
TN$416.68—
TX$416.68—
UT$416.68—
VA$416.68—
VI$416.68—
VT$416.68—
WA$416.68—
WI$416.68—
WV$416.68—
WY$416.68—
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 E2615 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E2601E2602E2603E2604E2605E2606E2607E2608E2609E2610E2611E2612

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