E2292 Planar seat for ped size wc

Seat, planar, for pediatric size wheelchair including fixed attaching hardware

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for E2292

21 of 22 payer prior-auth lists that name E2292 require prior authorization or set conditions: Blue Shield of California Promise Health Plan, Humana, Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of South Carolina, Molina Healthcare of Texas, Molina Healthcare of Utah, Molina Healthcare of Washington, Molina Healthcare of Wisconsin, Molina Healthcare, Inc. (national grid), UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of California Promise Health PlanPromise Health Plan Medi-CalCAprior auth requiredSep 1, 2026Medi-Cal Prior Authorization List
HumanaHumana Healthy HorizonsVAprior auth requiredJan 1, 2027Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL)
Molina Complete Care (Virginia)Medicare-only PA matrix for D-SNPVAprior auth requiredJan 1, 2022Medicare Prior Auth (PA) Code Matrix (Virginia), effective Q1 2022
Molina Healthcare of ArizonaMedicare-only PA matrix for D-SNPAZprior auth requiredJan 1, 2022Medicare Prior Auth (PA) Code Matrix (Arizona), effective Q1 2022
Molina Healthcare of CaliforniaMedicare AdvantageCAprior auth requiredJul 1, 2021Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021
Molina Healthcare of FloridaMedicare AdvantageFLprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021
Molina Healthcare of IdahoMedicare AdvantageIDprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
Molina Healthcare of MichiganExchangeMIprior auth requiredJul 1, 2021Molina Healthcare of Michigan PA Matrix, effective 7/1/2021
Molina Healthcare of NevadaMedicaidNVprior auth requiredOct 1, 2022Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022
Molina Healthcare of New MexicoMedicare AdvantageNMprior auth requiredJan 1, 2021Medicare Prior Auth (PA) Code Matrix (New Mexico), effective Q1 2021
Molina Healthcare of OhioMedicaid and MyCare Ohio (MMP) MedicaidOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioMedicare and MyCare Ohio (MMP) MedicareOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioExchangeOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of South CarolinaMedicare AdvantageSCprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (South Carolina), effective Q2 2021
Molina Healthcare of TexasExchangeTXprior auth requiredPA Modernization - PA requirements will be removed where coveredJan 1, 2024Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026
Molina Healthcare of UtahMedicare AdvantageUTprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021
Molina Healthcare of WashingtonMedicare AdvantageWAprior auth requiredApr 1, 2021Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021
Molina Healthcare of WisconsinMedicare AdvantageWIprior auth requiredOct 1, 2021Medicare Prior Auth (PA) Code Matrix (Wisconsin), effective Q4 2021
Molina Healthcare, Inc. (national grid)Molina national (MHI) Medicare gridAllprior auth requiredOct 1, 2021Medicare Prior Auth (PA) Code Matrix (national), effective Q4 2021
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 E2292

E2292 appears in 6 coverage policies from Aetna, Anthem, Capital Blue Cross, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaWheelchairs and Power Operated Vehicles (Scooters) (0271)listed, no stanceAug 21, 2026payer document
AnthemWheeled Mobility Devices: Wheelchair Accessories (CG-DME-34)covered if criteria are met (range E2291-E2295)Nov 6, 2025payer document
Capital Blue CrossManual Wheelchairs and Accessories (MP 6.059)covered if criteria are metSep 1, 2026payer document
CenteneWheelchair Seating (CP.MP.99)covered if criteria are metJan 1, 2024payer 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
Premera Blue CrossWheelchairs (Manual or Motorized) (1.01.501)
Page | 12 of 26 | ∞
listed, no stanceMay 11, 2026payer document

Recent prior-auth changes

  • Jan 1, 2027: PA added, Humana
  • Jan 1, 2026: PA removed, Molina Healthcare of Michigan
  • Mar 1, 2025: PA removed, Rocky Mountain Health Plans
  • Mar 1, 2025: PA removed, Rocky Mountain Health Plans
  • Feb 19, 2025: PA removed, Molina Healthcare of Texas
  • Feb 19, 2025: PA removed, Molina Healthcare of Texas
  • Jan 1, 2025: PA removed, Molina Healthcare of Texas
  • Jan 1, 2024: PA removed, Molina Healthcare of Michigan

Medicaid fee-for-service

Prior authorization required or conditional in CO, IL, IN, KY, MA, MD, MS, NY, VA, WA, WV.

  • CO: $509.64 (health_first_colorado), effective Jul 1, 2026
  • KS: $0.00 (default), effective Jun 1, 2015
  • NY: $356.11 (dme), effective Jul 1, 2026
  • OH: $350.00 (dme), effective Jul 1, 2021
  • TX: $0.00 (dmepos_tos_9_e_j_l_and_r, Home Health Dme), effective Jan 1, 2005
  • VA: $262.77 (dme), effective Dec 1, 2026
  • VT: $0.00 (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.