E1226 — Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
E1226 is a HCPCS Level II code for wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each. 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 E1226 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
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
- 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 E1226
- Long descriptor
- Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
- Short descriptor
- Manual fully reclining back
- Added
- January 1, 1986
- BETOS
- D1D
- Pricing indicator
- 00 — Not priced by Part B
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.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to E1226
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E1226 is not quite right, the correct code is very often within a few positions of it.
- E1195Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests
- E1200Amputee wheelchair, fixed full length arms, swing away detachable footrest
- E1220Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
- E1221Wheelchair with fixed arm, footrests
- E1222Wheelchair with fixed arm, elevating legrests
- E1223Wheelchair with detachable arms, footrests
- E1224Wheelchair with detachable arms, elevating legrests
- E1225Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
- E1227Special height arms for wheelchair
- E1228Special back height for wheelchair
- E1229Wheelchair, pediatric size, not otherwise specified
- E1230Power operated vehicle (three or four wheel nonhighway) specify brand name and model number
- E1231Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
- E1232Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system
- E1233Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system
- E1234Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system
Questions about E1226
What is HCPCS code E1226?
E1226 is a HCPCS Level II code for wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each. It sits in the Durable Medical Equipment section.
Does Medicare cover E1226?
The CMS HCPCS file marks E1226 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.