Funding

Java Cushion

Medicare Code

E2624: Skin Protection and Positioning Wheelchair Seat Cushion, Adjustable, Width Less than 22 inches, Any Depth

2017 Medicare Fee Schedule*

Non-Rural Fee

E2624 / NU: $295.07
E2624 / NU KU: $320.66
E2624 / RR: $29.51
E2624 / RR KU: $32.07

Rural Fee

Medicare did not publish a set allowable for the Rural Fee

Pricing Category

Inexpensive & routinely purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Java Cushion Funding (PDF)
ICD-10 Cushions (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Java Cushion Cover

Medicare Code

E2619: Replacement Cover for Wheelchair Seat Cushion or Back Cushion, Each
This item cannot be billed separately when the cushion itself is being billed. This is a replacement only billable code.

2017 Medicare Fee Schedule*

Non-Rural Fee

E2619 / NU: $45.78
E2619 / NU KU: $49.23
E2619 / RR: $4.58
E2619 / RR KU: $4.92

Rural Fee

Medicare did not publish a set allowable for the Rural Fee

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Java Cushion Funding (PDF)
ICD-10 Cushions (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Forward Cushion

Medicare Code

E2607: Skin Protection and Positioning Wheelchair Seat Cushion, width Less Than 22 inches, Any Depth

2017 Medical Fee Schedule*

Non-Rural Fee

E2607 / NU: Varies by state, please see document below
E2607 / NU KU: $278.11
E2607 / RR: Varies by state, please see document below
E2607 / RR KU: $27.81

Rural Fee

E2607 / NU:$212.61
E2607 / NU KU: Medicare did not publish a set allowable
E2607 / RR: $21.26
E2607 / RR KU: Medicare did not publish a set allowable

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).

Forward Cushion Funding (PDF)
E2607 Non-Rural Fee Schedule (PDF)
ICD-10 Cushions (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Forward Cushion Cover

Medicare Code

E2619: Replacement Cover for Wheelchair Seat Cushion or Back Cushion, Each
This item cannot be billed separately when the cushion itself is being billed. This is a replacement only billable code.

2017 Medicare Fee Schedule*

Non-Rural Fee

E2619 / NU: $45.78
E2619 / NU KU: $49.23
E2619 / RR: $4.58
E2619 / RR KU: $4.92

Rural Fee

Medicare did not publish a set allowable for the Rural Fee

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Forward Cushion Funding (PDF)
E2607 Non-Rural Fee Schedule (PDF)
ICD-10 Cushions (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Ride Custom Cushion and Ride Custom Cushion 2

Medicare Code

E2609: Custom Fabricated Wheelchair Seat Cushion, Any Size

2017 Medicare Fee Schedule

There is no set Medicare Fee Schedule for this HCPCs Code. This item is individually priced. Be sure to include the Manufacturer name and model name/number, and the MSRP. All parts and pieces tied to the custom back should be grouped into this one line when billing Medicare.

Custom Cushion Funding (PDF)
Custom Cushion 2 Funding (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Ride Custom Cushion Cover

Medicare Code

E2619: Replacement Cover for Wheelchair Seat Cushion or Back Cushion, Each
This item cannot be billed separately when the cushion itself is being billed. This is a replacement only billable code.

2017 Medicare Fee Schedule*

Non-Rural Fee

E2619 / NU: $45.78
E2619 / NU KU: $49.23
E2619 / RR: $4.58
E2619 / RR KU: $4.92

Rural Fee

Medicare did not publish a set allowable for the Rural Fee

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Custom Cushion Funding (PDF)
Custom Cushion 2 Funding (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Java® Back & Java Back Tall

Medicare Code

E2615: Positioning Wheelchair Back Cushion, Posterior-Lateral, width less than 22 inches, any height, including any type mounting hardware

2017 Medicare Fee Schedule*

Non-Rural Fee

E2615 / NU: Varies by state, please see document below
E2615 / NU KU: $434.00
E2615 / RR: Varies by state, please see document below
E2615 / RR KU: $43.41

Rural Fee

E2615 / NU: $368.66
E2615 / NU KU: Medicare did not publish a set allowable
E2615 / RR: $36.87
E2615 / RR KU: Medicare did not publish a set allowable

 

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Java Back (3") Funding (PDF)
Java Back (6") Funding (PDF)
E2615 Non-Rural Fee Schedule (PDF)
E2620 Non-Rural Fee Schedule (PDF)
ICD-10 Backs (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Java® Back (Regular/Deep), (Grande/Deep), (Tall/Deep)

Medicare Code

E2620: Positioning Wheelchair Back Cushion, Planar Back with Lateral Supports, Width Less than 22 inches, Any Height, Including Any Type Mounting Hardware

2017 Medicare Fee Schedule*

Non-Rural Fee

E2620 / NU: Varies by state, please see document below
E2620 / NU KU: $525.51
E2620 / RR: Varies by state, please see document below
E2620 / RR KU: $52.56

Rural Fee

E2620 / NU: $395.14
E2620 / NU KU: Medicare did not publish a set allowable
E2620 / RR: $39.51
E2620 / RR KU: Medicare did not publish a set allowable

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Java Back (3") Funding (PDF)
Java Back (6") Funding (PDF)
E2615 Non-Rural Fee Schedule (PDF)
E2620 Non-Rural Fee Schedule (PDF)
ICD-10 Backs (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Java® Decaf Back & Tall (includes Fixed, Non-Removable Hardware)

Medicare Code

E2615: Positioning Wheelchair Back Cushion, Posterior-Lateral, Width Less Than 22 inches, Any Height, Including Any Type Mounting Hardware

2017 Medicare Fee Schedule*

Non-Rural Fee

E2615 / NU: Varies by state, please see attached spreadsheet
E2615 / NU KU: $434.00
E2615 / RR: Varies by state, please see attached spreadsheet
E2615 / RR KU: $43.41

Rural Fee

E2615 / NU: $368.66
E2615 / NU KU: Medicare did not publish a set allowable
E2615 / RR: $36.87
E2615 / RR KU: Medicare did not publish a set allowable

Pricing Category

Inexpensive & Routinely Purchased

*Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).
Note: If the code is subject to competitive bidding, the allowable will be based on the single payment amount for the specific area.

Optional Quick Release Hardware

Under Medicare guidelines, there is not a specific HCPC code for quick release hardware to be used on a wheelchair back.  As the Wheelchair Back Code specifies, any type mounting hardware is included.  If the hardware is billed as a replacement part, code K0108 would have to be used; code E1028 is not allowed to be used for seat or back hardware.

Java Decaf Back Funding (PDF)
E2615 Non-Rural Fee Schedule (PDF)
ICD-10 Backs (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)

 


 

Ride® Custom Back

Medicare Code

E2617: Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type Mounting Hardware

2017 Medicare Fee Schedule

There is no set Medicare Fee Schedule for this HCPCs Code. This item is individually priced. Be sure to include the Manufacturer name and model name/number, and the MSRP. All parts and pieces tied to the custom back should be grouped into this one line when billing Medicare.

Custom Back Funding (PDF)
ICD-10 Backs (PDF)
Wheelchair Seating LCD (PDF)
WheelchairSeating Policy Article (PDF)

 


 

Corbac™ & Corbac Tall

Medicare Code

E2611: General Use Wheelchair Back Cushion, Width Less Than 22 inches, Any Height, Including Any Type Mounting Hardware

2017 Medicare Fee Schedule*

Non-Rural Fee

E2611 / NU: Varies by state, please see document below
E2611 / NU KU: $299.70
E2611 / RR: Varies by state, please see document below
E2611 / RR KU: $29.96

Rural Fee

E2611 / NU: $163.63
E2611 / NU KU: Medicare did not publish a set allowable
E2611 / RR: $16.36
E2611 / RR KU: Medicare did not publish a set allowable

Pricing Category

Inexpensive & Routinely Purchased

Allowable for KU modifier for Rural areas was not listed by Medicare, however will still be covered. The KU modifier is to be applied for items delivered January 1, 2016 - June 30, 2017 when the cushion is furnished in connection with a Group 3 complex rehabilitative power wheelchair (K0848 – K0864).

Corbac Funding (PDF)
E2611 Non-Rural Fee Schedule (PDF)
Wheelchair Seating LCD (PDF)
Wheelchair Seating Policy Article (PDF)