E1011 — Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)
E1011 is a HCPCS Level II code for modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair). It belongs to the Durable Medical Equipment section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of E1011 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for E1011
- Long descriptor
- Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)
- Short descriptor
- Ped wc modify width adjustm
- Added
- January 1, 2003
- BETOS
- D1D
- Pricing indicator
- 32 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Inexpensive and routinely purchased DME. Price subject to floors and ceilings.
Codes adjacent to E1011
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E1011 is not quite right, the correct code is very often within a few positions of it.
- E1003Wheelchair accessory, power seating system, recline only, without shear reduction
- E1004Wheelchair accessory, power seating system, recline only, with mechanical shear reduction
- E1005Wheelchair accessory, power seating system, recline only, with power shear reduction
- E1006Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction
- E1007Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction
- E1008Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction
- E1009Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each
- E1010Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair
- E1012Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each
- E1014Reclining back, addition to pediatric size wheelchair
- E1015Shock absorber for manual wheelchair, each
- E1016Shock absorber for power wheelchair, each
- E1017Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each
- E1018Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each
- E1020Residual limb support system for wheelchair, any type
- E1022Wheelchair transportation securement system, any type includes all components and accessories
Questions about E1011
What is HCPCS code E1011?
E1011 is a HCPCS Level II code for modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair). It sits in the Durable Medical Equipment section.
Does Medicare cover E1011?
The CMS HCPCS file marks E1011 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.