Manual wheelchair accessory, adapter for amputee, each
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 2 units per day (policy), rationale: Code Descriptor / CPT Instruction
DME supplier: max 2 units per day (policy), rationale: Code Descriptor / CPT Instruction
Medicare pricing for E0959
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $52.33 to $57.09 in the contiguous states; $61.22 to $84.74 in AK, HI, PR and VI; rural $53.55 to $61.28
NU-KU, inexpensive or routinely purchased (IN): non-rural $53.54 to $62.99 in the contiguous states; $61.23 to $107.11 in AK, HI, PR and VI; ceiling $62.99, floor $53.54
RR (rental), inexpensive or routinely purchased (IN): non-rural $5.23 to $5.71 in the contiguous states; $6.11 to $8.47 in AK, HI, PR and VI; rural $5.39 to $6.15
RR-KU, inexpensive or routinely purchased (IN): non-rural $5.38 to $6.33 in the contiguous states; $6.10 to $10.72 in AK, HI, PR and VI; ceiling $6.33, floor $5.38
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $39.25 to $42.82 in the contiguous states; $47.23 to $63.56 in AK, HI, PR and VI; rural $40.52 to $46.17
UE-KU, inexpensive or routinely purchased (IN): non-rural $40.55 to $47.70 in the contiguous states; $47.70 to $80.35 in AK, HI, PR and VI; ceiling $47.70, floor $40.55
Payer policies and prior authorization for E0959
1 of 1 payer prior-auth lists that name E0959 require prior authorization or set conditions: Rocky Mountain Health Plans.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.