E2619 — Replacement cover for wheelchair seat cushion or back cushion, each
HCPCS Level II E-code · short descriptor: “Replace cover w/c seat cush”
- 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
- 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 2026-10-26; 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 2026-10-26; 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.
E2619 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $61.28 to $68.45 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $62.16 | — |
| AL | $61.28 | $62.16 |
| AR | $61.28 | $62.16 |
| AZ | $61.28 | $62.16 |
| CA | $61.28 | $62.16 |
| CO | $61.28 | $62.16 |
| CT | $61.28 | $62.16 |
| DC | $61.28 | $62.16 |
| DE | $61.28 | $62.16 |
| FL | $61.28 | $62.16 |
| GA | $61.28 | $62.16 |
| HI | $62.16 | — |
| IA | $61.28 | $62.16 |
| ID | $61.28 | $62.16 |
| IL | $61.28 | $62.16 |
| IN | $61.28 | $62.16 |
| KS | $61.28 | $62.16 |
| KY | $61.28 | $62.16 |
| LA | $61.28 | $62.16 |
| MA | $61.28 | $62.16 |
| MD | $61.28 | $62.16 |
| ME | $61.28 | $62.16 |
| MI | $61.28 | $62.16 |
| MN | $61.28 | $62.16 |
| MO | $61.28 | $62.16 |
| MS | $61.28 | $62.16 |
| MT | $61.28 | $62.16 |
| NC | $61.28 | $62.16 |
| ND | $61.28 | $62.16 |
| NE | $61.28 | $62.16 |
| NH | $61.28 | $62.16 |
| NJ | $61.28 | $62.16 |
| NM | $61.28 | $62.16 |
| NV | $61.28 | $62.16 |
| NY | $61.28 | $62.16 |
| OH | $61.28 | $62.16 |
| OK | $61.28 | $62.16 |
| OR | $61.28 | $62.16 |
| PA | $61.28 | $62.16 |
| PR | $68.45 | — |
| RI | $61.28 | $62.16 |
| SC | $61.28 | $62.16 |
| SD | $61.28 | $62.16 |
| TN | $61.28 | $62.16 |
| TX | $61.28 | $62.16 |
| UT | $61.28 | $62.16 |
| VA | $61.28 | $62.16 |
| VI | $62.16 | — |
| VT | $61.28 | $62.16 |
| WA | $61.28 | $62.16 |
| WI | $61.28 | $62.16 |
| WV | $61.28 | $62.16 |
| WY | $61.28 | $62.16 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $66.73 to $73.94 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $66.73 | — |
| AL | — | $66.73 |
| AR | — | $66.73 |
| AZ | — | $66.73 |
| CA | — | $66.73 |
| CO | — | $66.73 |
| CT | — | $66.73 |
| DC | — | $66.73 |
| DE | — | $66.73 |
| FL | — | $66.73 |
| GA | — | $66.73 |
| HI | $66.73 | — |
| IA | — | $66.73 |
| ID | — | $66.73 |
| IL | — | $66.73 |
| IN | — | $66.73 |
| KS | — | $66.73 |
| KY | — | $66.73 |
| LA | — | $66.73 |
| MA | — | $66.73 |
| MD | — | $66.73 |
| ME | — | $66.73 |
| MI | — | $66.73 |
| MN | — | $66.73 |
| MO | — | $66.73 |
| MS | — | $66.73 |
| MT | — | $66.73 |
| NC | — | $66.73 |
| ND | — | $66.73 |
| NE | — | $66.73 |
| NH | — | $66.73 |
| NJ | — | $66.73 |
| NM | — | $66.73 |
| NV | — | $66.73 |
| NY | — | $66.73 |
| OH | — | $66.73 |
| OK | — | $66.73 |
| OR | — | $66.73 |
| PA | — | $66.73 |
| PR | $73.94 | — |
| RI | — | $66.73 |
| SC | — | $66.73 |
| SD | — | $66.73 |
| TN | — | $66.73 |
| TX | — | $66.73 |
| UT | — | $66.73 |
| VA | — | $66.73 |
| VI | $66.73 | — |
| VT | — | $66.73 |
| WA | — | $66.73 |
| WI | — | $66.73 |
| WV | — | $66.73 |
| WY | — | $66.73 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $63.02 to $75.61 depending on state and rural status.
Former-CBA payment limits: ceiling $63.02 · floor $53.57
| State | Non-rural | Rural |
|---|---|---|
| AK | $63.02 | — |
| AL | $63.02 | — |
| AR | $63.02 | — |
| AZ | $63.02 | — |
| CA | $63.02 | — |
| CO | $63.02 | — |
| CT | $63.02 | — |
| DC | $63.02 | — |
| DE | $63.02 | — |
| FL | $63.02 | — |
| GA | $63.02 | — |
| HI | $63.02 | — |
| IA | $63.02 | — |
| ID | $63.02 | — |
| IL | $63.02 | — |
| IN | $63.02 | — |
| KS | $63.02 | — |
| KY | $63.02 | — |
| LA | $63.02 | — |
| MA | $63.02 | — |
| MD | $63.02 | — |
| ME | $63.02 | — |
| MI | $63.02 | — |
| MN | $63.02 | — |
| MO | $63.02 | — |
| MS | $63.02 | — |
| MT | $63.02 | — |
| NC | $63.02 | — |
| ND | $63.02 | — |
| NE | $63.02 | — |
| NH | $63.02 | — |
| NJ | $63.02 | — |
| NM | $63.02 | — |
| NV | $63.02 | — |
| NY | $63.02 | — |
| OH | $63.02 | — |
| OK | $63.02 | — |
| OR | $63.02 | — |
| PA | $63.02 | — |
| PR | $75.61 | — |
| RI | $63.02 | — |
| SC | $63.02 | — |
| SD | $63.02 | — |
| TN | $63.02 | — |
| TX | $63.02 | — |
| UT | $63.02 | — |
| VA | $63.02 | — |
| VI | $63.02 | — |
| VT | $63.02 | — |
| WA | $63.02 | — |
| WI | $63.02 | — |
| WV | $63.02 | — |
| WY | $63.02 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.13 to $6.86 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.22 | — |
| AL | $6.13 | $6.22 |
| AR | $6.13 | $6.22 |
| AZ | $6.13 | $6.22 |
| CA | $6.13 | $6.22 |
| CO | $6.13 | $6.22 |
| CT | $6.13 | $6.22 |
| DC | $6.13 | $6.22 |
| DE | $6.13 | $6.22 |
| FL | $6.13 | $6.22 |
| GA | $6.13 | $6.22 |
| HI | $6.22 | — |
| IA | $6.13 | $6.22 |
| ID | $6.13 | $6.22 |
| IL | $6.13 | $6.22 |
| IN | $6.13 | $6.22 |
| KS | $6.13 | $6.22 |
| KY | $6.13 | $6.22 |
| LA | $6.13 | $6.22 |
| MA | $6.13 | $6.22 |
| MD | $6.13 | $6.22 |
| ME | $6.13 | $6.22 |
| MI | $6.13 | $6.22 |
| MN | $6.13 | $6.22 |
| MO | $6.13 | $6.22 |
| MS | $6.13 | $6.22 |
| MT | $6.13 | $6.22 |
| NC | $6.13 | $6.22 |
| ND | $6.13 | $6.22 |
| NE | $6.13 | $6.22 |
| NH | $6.13 | $6.22 |
| NJ | $6.13 | $6.22 |
| NM | $6.13 | $6.22 |
| NV | $6.13 | $6.22 |
| NY | $6.13 | $6.22 |
| OH | $6.13 | $6.22 |
| OK | $6.13 | $6.22 |
| OR | $6.13 | $6.22 |
| PA | $6.13 | $6.22 |
| PR | $6.86 | — |
| RI | $6.13 | $6.22 |
| SC | $6.13 | $6.22 |
| SD | $6.13 | $6.22 |
| TN | $6.13 | $6.22 |
| TX | $6.13 | $6.22 |
| UT | $6.13 | $6.22 |
| VA | $6.13 | $6.22 |
| VI | $6.22 | — |
| VT | $6.13 | $6.22 |
| WA | $6.13 | $6.22 |
| WI | $6.13 | $6.22 |
| WV | $6.13 | $6.22 |
| WY | $6.13 | $6.22 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.67 to $7.41 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.67 | — |
| AL | — | $6.67 |
| AR | — | $6.67 |
| AZ | — | $6.67 |
| CA | — | $6.67 |
| CO | — | $6.67 |
| CT | — | $6.67 |
| DC | — | $6.67 |
| DE | — | $6.67 |
| FL | — | $6.67 |
| GA | — | $6.67 |
| HI | $6.67 | — |
| IA | — | $6.67 |
| ID | — | $6.67 |
| IL | — | $6.67 |
| IN | — | $6.67 |
| KS | — | $6.67 |
| KY | — | $6.67 |
| LA | — | $6.67 |
| MA | — | $6.67 |
| MD | — | $6.67 |
| ME | — | $6.67 |
| MI | — | $6.67 |
| MN | — | $6.67 |
| MO | — | $6.67 |
| MS | — | $6.67 |
| MT | — | $6.67 |
| NC | — | $6.67 |
| ND | — | $6.67 |
| NE | — | $6.67 |
| NH | — | $6.67 |
| NJ | — | $6.67 |
| NM | — | $6.67 |
| NV | — | $6.67 |
| NY | — | $6.67 |
| OH | — | $6.67 |
| OK | — | $6.67 |
| OR | — | $6.67 |
| PA | — | $6.67 |
| PR | $7.41 | — |
| RI | — | $6.67 |
| SC | — | $6.67 |
| SD | — | $6.67 |
| TN | — | $6.67 |
| TX | — | $6.67 |
| UT | — | $6.67 |
| VA | — | $6.67 |
| VI | $6.67 | — |
| VT | — | $6.67 |
| WA | — | $6.67 |
| WI | — | $6.67 |
| WV | — | $6.67 |
| WY | — | $6.67 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.28 to $7.60 depending on state and rural status.
Former-CBA payment limits: ceiling $6.28 · floor $5.34
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.28 | — |
| AL | $6.28 | — |
| AR | $6.28 | — |
| AZ | $6.28 | — |
| CA | $6.28 | — |
| CO | $6.28 | — |
| CT | $6.28 | — |
| DC | $6.28 | — |
| DE | $6.28 | — |
| FL | $6.28 | — |
| GA | $6.28 | — |
| HI | $6.28 | — |
| IA | $6.28 | — |
| ID | $6.28 | — |
| IL | $6.28 | — |
| IN | $6.28 | — |
| KS | $6.28 | — |
| KY | $6.28 | — |
| LA | $6.28 | — |
| MA | $6.28 | — |
| MD | $6.28 | — |
| ME | $6.28 | — |
| MI | $6.28 | — |
| MN | $6.28 | — |
| MO | $6.28 | — |
| MS | $6.28 | — |
| MT | $6.28 | — |
| NC | $6.28 | — |
| ND | $6.28 | — |
| NE | $6.28 | — |
| NH | $6.28 | — |
| NJ | $6.28 | — |
| NM | $6.28 | — |
| NV | $6.28 | — |
| NY | $6.28 | — |
| OH | $6.28 | — |
| OK | $6.28 | — |
| OR | $6.28 | — |
| PA | $6.28 | — |
| PR | $7.60 | — |
| RI | $6.28 | — |
| SC | $6.28 | — |
| SD | $6.28 | — |
| TN | $6.28 | — |
| TX | $6.28 | — |
| UT | $6.28 | — |
| VA | $6.28 | — |
| VI | $6.28 | — |
| VT | $6.28 | — |
| WA | $6.28 | — |
| WI | $6.28 | — |
| WV | $6.28 | — |
| WY | $6.28 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $45.96 to $51.33 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $46.64 | — |
| AL | $45.96 | $46.64 |
| AR | $45.96 | $46.64 |
| AZ | $45.96 | $46.64 |
| CA | $45.96 | $46.64 |
| CO | $45.96 | $46.64 |
| CT | $45.96 | $46.64 |
| DC | $45.96 | $46.64 |
| DE | $45.96 | $46.64 |
| FL | $45.96 | $46.64 |
| GA | $45.96 | $46.64 |
| HI | $46.64 | — |
| IA | $45.96 | $46.64 |
| ID | $45.96 | $46.64 |
| IL | $45.96 | $46.64 |
| IN | $45.96 | $46.64 |
| KS | $45.96 | $46.64 |
| KY | $45.96 | $46.64 |
| LA | $45.96 | $46.64 |
| MA | $45.96 | $46.64 |
| MD | $45.96 | $46.64 |
| ME | $45.96 | $46.64 |
| MI | $45.96 | $46.64 |
| MN | $45.96 | $46.64 |
| MO | $45.96 | $46.64 |
| MS | $45.96 | $46.64 |
| MT | $45.96 | $46.64 |
| NC | $45.96 | $46.64 |
| ND | $45.96 | $46.64 |
| NE | $45.96 | $46.64 |
| NH | $45.96 | $46.64 |
| NJ | $45.96 | $46.64 |
| NM | $45.96 | $46.64 |
| NV | $45.96 | $46.64 |
| NY | $45.96 | $46.64 |
| OH | $45.96 | $46.64 |
| OK | $45.96 | $46.64 |
| OR | $45.96 | $46.64 |
| PA | $45.96 | $46.64 |
| PR | $51.33 | — |
| RI | $45.96 | $46.64 |
| SC | $45.96 | $46.64 |
| SD | $45.96 | $46.64 |
| TN | $45.96 | $46.64 |
| TX | $45.96 | $46.64 |
| UT | $45.96 | $46.64 |
| VA | $45.96 | $46.64 |
| VI | $46.64 | — |
| VT | $45.96 | $46.64 |
| WA | $45.96 | $46.64 |
| WI | $45.96 | $46.64 |
| WV | $45.96 | $46.64 |
| WY | $45.96 | $46.64 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $50.07 to $55.43 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $50.07 | — |
| AL | — | $50.07 |
| AR | — | $50.07 |
| AZ | — | $50.07 |
| CA | — | $50.07 |
| CO | — | $50.07 |
| CT | — | $50.07 |
| DC | — | $50.07 |
| DE | — | $50.07 |
| FL | — | $50.07 |
| GA | — | $50.07 |
| HI | $50.07 | — |
| IA | — | $50.07 |
| ID | — | $50.07 |
| IL | — | $50.07 |
| IN | — | $50.07 |
| KS | — | $50.07 |
| KY | — | $50.07 |
| LA | — | $50.07 |
| MA | — | $50.07 |
| MD | — | $50.07 |
| ME | — | $50.07 |
| MI | — | $50.07 |
| MN | — | $50.07 |
| MO | — | $50.07 |
| MS | — | $50.07 |
| MT | — | $50.07 |
| NC | — | $50.07 |
| ND | — | $50.07 |
| NE | — | $50.07 |
| NH | — | $50.07 |
| NJ | — | $50.07 |
| NM | — | $50.07 |
| NV | — | $50.07 |
| NY | — | $50.07 |
| OH | — | $50.07 |
| OK | — | $50.07 |
| OR | — | $50.07 |
| PA | — | $50.07 |
| PR | $55.43 | — |
| RI | — | $50.07 |
| SC | — | $50.07 |
| SD | — | $50.07 |
| TN | — | $50.07 |
| TX | — | $50.07 |
| UT | — | $50.07 |
| VA | — | $50.07 |
| VI | $50.07 | — |
| VT | — | $50.07 |
| WA | — | $50.07 |
| WI | — | $50.07 |
| WV | — | $50.07 |
| WY | — | $50.07 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $47.32 to $56.68 depending on state and rural status.
Former-CBA payment limits: ceiling $47.32 · floor $40.22
| State | Non-rural | Rural |
|---|---|---|
| AK | $47.32 | — |
| AL | $47.32 | — |
| AR | $47.32 | — |
| AZ | $47.32 | — |
| CA | $47.32 | — |
| CO | $47.32 | — |
| CT | $47.32 | — |
| DC | $47.32 | — |
| DE | $47.32 | — |
| FL | $47.32 | — |
| GA | $47.32 | — |
| HI | $47.32 | — |
| IA | $47.32 | — |
| ID | $47.32 | — |
| IL | $47.32 | — |
| IN | $47.32 | — |
| KS | $47.32 | — |
| KY | $47.32 | — |
| LA | $47.32 | — |
| MA | $47.32 | — |
| MD | $47.32 | — |
| ME | $47.32 | — |
| MI | $47.32 | — |
| MN | $47.32 | — |
| MO | $47.32 | — |
| MS | $47.32 | — |
| MT | $47.32 | — |
| NC | $47.32 | — |
| ND | $47.32 | — |
| NE | $47.32 | — |
| NH | $47.32 | — |
| NJ | $47.32 | — |
| NM | $47.32 | — |
| NV | $47.32 | — |
| NY | $47.32 | — |
| OH | $47.32 | — |
| OK | $47.32 | — |
| OR | $47.32 | — |
| PA | $47.32 | — |
| PR | $56.68 | — |
| RI | $47.32 | — |
| SC | $47.32 | — |
| SD | $47.32 | — |
| TN | $47.32 | — |
| TX | $47.32 | — |
| UT | $47.32 | — |
| VA | $47.32 | — |
| VI | $47.32 | — |
| VT | $47.32 | — |
| WA | $47.32 | — |
| WI | $47.32 | — |
| WV | $47.32 | — |
| WY | $47.32 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2619 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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