Article Detail - JA DME

CMS published a final Benefit Category Determination and National Coverage Determination (NCD) for seat elevation equipment (power operated) on power wheelchairs for dates of service May 16, 2023, and after. For more information, review the National Coverage Analysis and Coverage, Coding and Payment for Power Seat Elevation Equipment on Power Wheelchairs.

Suppliers must use HCPCS E2300 (wheelchair accessory, power seat elevation system, any type) when billing to Medicare. Additionally, HCPCS codes K0830 (Power Wheelchair, Group 2 Standard, Seat Elevator, Sling/Solid Seat/Back, Patient Weight Capacity Up to and Including 300 Pounds) or K0831 (Power Wheelchair, Group 2 Standard, Seat Elevator, Captains Chair, Patient Weight Capacity Up To and Including 300 Pounds) must be used to submit claims for individuals with Medicare using seat elevation on Group 2 power wheelchairs that are not complex rehabilitative power-driven wheelchairs. Claims submitted using HCPCS code E2300 for power seat elevation equipment on wheelchairs other than Group 5 and complex rehabilitative power-driven wheelchairs will be denied.

Modifiers

Pricing modifiers must be added to the claim when billing the E2300 and K0830 and K0831. The capped rental modifiers KH, KI, or KJ and/or rent/purchase modifiers BP or BR apply depending on the billed month and rental/purchase option chosen. For more information review our website on Modifiers.

Gap-Filling

CMS has not set a fee schedule for E2300, K0830, and K0831. Allowed amounts for these HCPCS will be calculated based on gap-filling regulations. For additional information on gap-filling, review Pricing on our website.