Funding Information

US Funding:
1. Medicare and the Corbac
2. Medicare and the Ride Custom Cushion
3. Medicare and the Forward Cushion

Canadian Funding:
Ontario ADP Funding for Ride Cushions
Ontario ADP Funding for Corbac
Ontario ADP Funding for the Forward Cushion

Medicare and the Corbac:
Medicare code for the Ride Corbac Adjustable Back Support:

Code: E2611 General use wheelchair back cushion, width less than 22 inches,
any height, including any type mounting hardware.

Claims for the Ride Corbac under E2611 must clearly state:

1. The product name followed by "back cushion": Ride Corbac back cushion
2. The manufacturer: Ride Designs, a Division of Aspen Seating
3. The model number: CB-XX00
4. The width of the Corbac: XX

Coverage Policy:

Simply put, if a person qualifies for a wheelchair under medicare, then they qualify for a general use back support.

Medicare Code for the Ride Custom Cushion:

Code: E2609, Custom Fabricated Seat Cushion

Coverage Policy

A custom fabricated seat cushion (E2609) is covered if the following criteria are met:

1) Patient meets all of the criteria for a prefabricated skin protection seat cushion or positioning seat cushion;

2) There is a comprehensive written evaluation by a licensed clinician (who is not an employee of or otherwise paid by a supplier) which clearly explains why a prefabricated seating system is not sufficient to meet the patient's seating and positioning needs.

To get custom seating funded, one must not only be able to justify the prescribed intervention, but document what has been used, assessed, and ruled out, and why other simpler less costly options didn't work.

• Letter of Medical Necessity justification statement suggestions
  for the Ride Custom Cushion (PDF document)
  Download Adobe Acrobat Reader free for PDF files

If a custom fabricated cushion is provided for a patient who does not meet the stated coverage criteria, but the coverage criteria for another type of cushion are met, payment will be based on the allowance for the least costly medically appropriate alternative; if the criteria for another type of cushion are not met, the custom fabricated cushion will be denied as not medically necessary.

Medicare and the Forward Cushion:
E2607 Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth.

Ontario Suppliers:

The following codes have been approved by the Ontario Ministry of Health and Long-term Care for the Assistive Devices Program (ADP) for Ride Designs cushions and back supports:

Seats	ADP Code	ADP Price	Description
Custom Cushions	SESR40005	1624.00	Standard (12-20"), extra wide (21-22"), custom sizes, extra cover and modifications included.
Forward Cushion	ADP Code	ADP Price	Description
FC-Foward Cushions	SESR41020	550.00	1414 to FC-2020
Back Support	ADP Code	ADP Price	Description
Back Support CB-1400 to CB-1920	SEBR40005	467.00	CORBAC ADJUSTABLE CONTOUR BACK SUPPORT, ALL SIZES