E1039 Transport chair pt wt >300lb

Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for E1039

DMEPOS fee schedule, July 2026 (DME26-C)

Payer policies and prior authorization for E1039

3 of 3 payer prior-auth lists that name E1039 require prior authorization or set conditions: Blue Cross and Blue Shield of New Mexico, Rocky Mountain Health Plans, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of New MexicoTurquoise Care (New Mexico Medicaid)NMprior auth requiredOct 1, 2026New Mexico Medicaid Benefit Preauthorization Procedure Code List 10/1/26
Rocky Mountain Health PlansRocky Mountain Medicare Advantage D-SNPCOprior auth requiredFeb 1, 2025Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth under conditionsCost over $500Jul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026

Payer coverage policies that name E1039

E1039 appears in 3 coverage policies from Aetna, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaWheelchairs and Power Operated Vehicles (Scooters) (0271)not coveredAug 21, 2026payer document
Capital Blue CrossManual Wheelchairs and Accessories (MP 6.059)covered if criteria are metSep 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Wheelchairs and Accessories (DME101.010)
HCPCS Codes E0950, E0951, E0952, E0953, E0954, E0955, E0956, E0957, E0958, E0959,
listed, no stanceJan 1, 2026payer document

Recent prior-auth changes

  • May 1, 2026: PA removed, Blue Shield of California Promise Health Plan

Medicaid fee-for-service

Prior authorization required or conditional in CO, IN, KY, MA, MS, VT.

  • AZ: $1.28 (dme_rentals), effective Oct 1, 2026
  • CO: $333.07 (chp_plus, non-facility), effective Jul 1, 2026
  • IN: $34.04 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2025
  • KS: $0.25 (default), effective Jan 1, 2005
  • KY: $372.30 (dme), effective Jan 1, 2026
  • MD: $32.83 (dme), effective Apr 1, 2026
  • MS: $1.24 (comprehensive), effective Jul 1, 2026
  • NE: $418.49 (dme), effective Jul 1, 2026
  • OH: $341.55 (dme), effective Jan 1, 2017
  • OK: $39.09 (dme), effective Jan 1, 2026
  • VT: $408.30 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.