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HCPCS E0995 · Level II · DME code

E0995: Wheelchair accessory, calf rest/pad, replacement only, each, HCPCS Level II DME code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for E0995

Medicare payment
$31.74 to $33.40
DMEPOS non-rural state fees (NU)
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
2
MAI 2
OPPS status
SI B
Non-allowed item or service for OPPS
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

HCPCS Level II E0995 reads "Wheelchair accessory, calf rest/pad, replacement only, each" in the October 2026 file; it dates from 1986. E0995 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $31.74 in AL, CT, FL and 13 more to $33.40 in AR, AZ, CA and 26 more, rural $31.74 to $35.37; NU-KE (purchased, new) no state fee, rural $34.24 to $38.07; NU-KU (purchased, new) $31.73 in AL, CT, FL and 13 more to $37.33 in AR, CA, CO and 22 more (floor $31.73, ceiling $37.33) (6 more modifier rows on this page), October 2026. MUE limits for E0995: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 2 (MAI 2, Anatomic Consideration). 1 active LCD lists E0995: L33792 (Wheelchair Options/Accessories). OPPS status indicator B: Non-allowed item or service for OPPS. HCPCS record: BETOS D1D (wheelchairs); pricing indicator 00; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). 44 other active codes open with "Wheelchair accessory"; related codes: E0990, E1007, E0978, E0973.

E0995 descriptor and code status

The October 2026 HCPCS Level II file describes E0995 as “Wheelchair accessory, calf rest/pad, replacement only, each”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0995
FieldValue
Short descriptorWc calf rest, pad replacemnt
Added to HCPCS1986-01-01
Last actionN (no maintenance), effective 2017-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator00: not separately priced by Part B
BETOS categoryD1D: wheelchairs
Type of serviceA: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME

Medicare payment for E0995

E0995 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $31.74 in AL, CT, FL and 13 more to $33.40 in AR, AZ, CA and 26 more, rural $31.74 to $35.37; NU-KE (purchased, new) no state fee, rural $34.24 to $38.07; NU-KU (purchased, new) $31.73 in AL, CT, FL and 13 more to $37.33 in AR, CA, CO and 22 more (floor $31.73, ceiling $37.33) (6 more modifier rows on this page), October 2026. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category IN (inexpensive and other routinely purchased items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for E0995 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
NU (purchased, new)—$31.74 (AL, CT, FL…) to $33.40 (AR, AZ, CA…)$31.74 (AL, CT, FL…) to $35.37 (AR, CA, CO…)AK $80.63, HI $38.22, PR $46.11, VI $31.74
NU (purchased, new), KE (competitive bid round 1, non-bid base equipment)——$34.24 (AL, CT, FL…) to $38.07 (AR, CA, CO…)AK $89.90, HI $41.34, PR $50.37, VI $34.87
NU (purchased, new), KU (competitive bidding program 3 item)$31.73 / $37.33$31.73 (AL, CT, FL…) to $37.33 (AR, CA, CO…)—AK $127.86, HI $43.03, PR $58.83, VI $31.73
RR (rental)—$3.18 (AL, CT, FL…) to $3.34 (AR, AZ, CA…)$3.18 (AL, CT, FL…) to $3.54 (AR, AZ, CA…)AK $8.08, HI $3.83, PR $5.34, VI $3.18
RR (rental), KE (competitive bid round 1, non-bid base equipment)——$3.44 (AL, CT, FL…) to $3.82 (AR, AZ, CA…)AK $9.01, HI $4.14, PR $5.87, VI $3.49
RR (rental), KU (competitive bidding program 3 item)$3.20 / $3.76$3.20 (AL, CT, FL…) to $3.76 (AR, AZ, CA…)—AK $12.80, HI $4.31, PR $7.34, VI $3.20
UE (purchased, used)—$23.78 (AL, CT, FL…) to $25.05 (AR, AZ, CA…)$23.78 (AL, CT, FL…) to $26.51 (AR, CA, CO…)AK $60.49, HI $28.66, PR $42.56, VI $23.78
UE (purchased, used), KE (competitive bid round 1, non-bid base equipment)——$25.65 (AL, CT, FL…) to $28.54 (AR, CA, CO…)AK $67.44, HI $31.00, PR $46.91, VI $26.14
UE (purchased, used), KU (competitive bidding program 3 item)$23.78 / $27.98$23.78 (AL, CT, FL…) to $27.98 (AR, CA, CO…)—AK $95.92, HI $32.27, PR $60.08, VI $23.78

Hospital outpatient (OPPS Addendum B)

Status indicator B (Non-allowed item or service for OPPS), with no separate OPPS payment rate.

Medically Unlikely Edits for E0995

MUE limits for E0995: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 2 (MAI 2, Anatomic Consideration). The DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for E0995 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital22 Date of Service Edit: PolicyAnatomic Consideration
DME supplier22 Date of Service Edit: PolicyAnatomic Consideration

The MUE lookup for E0995 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0995 in v323r0.

E0995 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check E0995 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0995

1 active Local Coverage Determination and 0 billing and coding articles list E0995. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on E0995

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E0995

CARC 151 · N362

units of E0995 exceed the DME supplier MUE of 2 per date of service

CARC 4

the NU, KE, KU payment modifier is missing or does not match the item

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for E0995 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for E0995 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E0995

What does HCPCS code E0995 describe?

"Wheelchair accessory, calf rest/pad, replacement only, each" (short descriptor "Wc calf rest, pad replacemnt"), in the E section (durable medical equipment). Added 1986-01-01; last action N (no maintenance) effective 2017-01-01.

Is E0995 a CPT code?

No: CMS maintains E0995 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for E0995?

E0995 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $31.74 in AL, CT, FL and 13 more to $33.40 in AR, AZ, CA and 26 more, rural $31.74 to $35.37; NU-KE (purchased, new) no state fee, rural $34.24 to $38.07; NU-KU (purchased, new) $31.73 in AL, CT, FL and 13 more to $37.33 in AR, CA, CO and 22 more (floor $31.73, ceiling $37.33) (6 more modifier rows on this page), October 2026.

How many units of E0995 can be billed per day?

MUE limits for E0995: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 2, Anatomic Consideration); DME supplier 2 (MAI 2, Anatomic Consideration). For the DME supplier MUE (MAI 2), units above 2 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover E0995?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists E0995: L33792 (Wheelchair Options/Accessories).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.