HCPCS E1195 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Durable Medical Equipment • Amputee Wheelchairs |
| Complexity Level | High |
National average reimbursement for HCPCS E1195 by major payers:
$1,138.39
$786.56
$837.30
$1,512.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS E1195 | ||||||
United | E1195 | $570.09 | 1669488250 - ELBERT MEMORIAL HOSPITAL | 586002491 - (GA) ELBERT MEMORIAL HOSPITAL | GA | Critical Access Hospital (282NC0060X) |
United | E1195 | $681.90 | 1790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH | 582002413 | GA | General Acute Care Hospital (282N00000X) |
United | E1195 | $694.21 | 1083711691 - TY COBB HEALTHCARE SYSTEM, COBB MEMORIAL HOSPITAL | 580633978 - (GA) COMMUNITY SERVICES GROUP INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | E1195 | $634.46 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | E1195 | $71.31 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | E1195 | $737.13 | 1801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM | 581790149 - (GA) TANNER MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | E1195 | $738.60 | 1881144889 - NGMC BARROW LLC, NGMC BARROW | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | E1195 | $100.91 | 1518912666 - STEPHENS COUNTY ANESTHESIA SERVICES,LLC | 300429607 - (GA) STEPHENS COUNTY ANESTHESIA SERVICESLLC | GA | Rural Acute Care Hospital (282NR1301X) |
United | E1195 | $511.29 | 1083711691 - TY COBB HEALTHCARE SYSTEM, COBB MEMORIAL HOSPITAL | 580633978 - (GA) COMMUNITY SERVICES GROUP INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | E1195 | $2059.05 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E1195 | $96.11 | 1619910627 - BRADLEY WEISNER | 562107759 - UROLOGY SPECIALISTS OF THE CAROLINAS, PLLC | NC | Urology Physician (208800000X) |
United | E1195 | $611.67 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | E1195 | $74.43 | 1629185285 - BACON COUNTY HEALTH SERVICES, INC. | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | E1195 | $552.79 | 1306136551 - UJUKA ILOABUCHI | 582483738 | GA | Women's Hospital (282NW0100X) |
United | E1195 | $74.43 | 1154377166 - FLOYD HEALTHCARE MANAGEMENT INC, ATRIUM HEALTH FLOYD MEDICAL CENTER | 581973570 - (GA) FLOYD HEALTHCARE MANAGEMENT, INC. | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS E1195 vs. Other Amputee Wheelchairs Codes
The HCPCS E1195 code is part of the Durable Medical Equipment services used for Amputee Wheelchairs. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS E1195 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| E1190-HCPCS | Moderate | Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests |
| E1195-HCPCS | High | Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests |
| E1200-HCPCS | Moderate | Amputee wheelchair, fixed full length arms, swing away detachable footrest |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1195. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1195 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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