WASHINGTON–A joint durable medical equipment Medicare Administrative contractor (DME MAC) publication announced new HCPCS codes for wheelchair accessories will go into effect on or after April 1, 2025. The Centers for Medicare & Medicaid (CMS) is revising HCPCS code E1028 and creating three new HCPCS codes for wheelchair accessories:
- Revise existing HCPCS Level II code E1028, "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory" to instead read "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other"
- Establish a new HCPCS Level II code E1032, "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface."
- Establish a new HCPCS Level II code E1033, "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type"
- Establish a new HCPCS Level II code E1034, "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type"
According to the National Coalition for Assistive & Rehab Technology (NCART), codes E1032, E1033 and E1034 are in the capped rental payment category. To avoid potential overpayments, items previously coded and billed under E1028 that are still in the capped rental period should continue to be billed under code E1028 rather than switching mid-capped rental to the new HCPCS code. Codes E1032, E1033 and E1034 must only be billed for new items dispensed with dates of service on or after April 1, 2025.
The two DME MACs involved in the publication include Noridian and CGS.
Fee schedules for the new codes have not been posted.
For questions about correct coding, contact the PDAC HCPCS Helpline at (877) 735-1326 during the hours of 9:30 a.m. to 5 p.m. ET, Monday through Friday. Visit the PDAC website to chat with a representative or select the "Contact Us" button at the top of the PDAC website for email, FAX or postal mail information.