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See a sample rate comparisonHealthcare 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 Pediatric Wheelchairs |
| Complexity Level | High |
| Medicaid Fee Schedule | $2,007.865 median of the 4 states in the free preview · View Medicaid rates for E1236 |
National average reimbursement for HCPCS E1236 by major payers:

$1,481.97

$1,131.13

$766.01

$2,692.28
Choose a payer to see a sample of rates for HCPCS E1236.
Emory Healthcare
Emory University
Aztec Urgent Care, LLC
Aztec Urgent Care LLC
Devon Daney
Aztec Urgent Care LLC
Phoebe Putney Memorial Hospital Inc, Phoebe Putney Memorial Hosptial
Phoebe Physician Group Inc
Miguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS E1236 vs. Other Pediatric Wheelchairs Codes
The HCPCS E1236 code is part of the Durable Medical Equipment services used for Pediatric 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 E1236 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 |
|---|---|---|
| E1235-HCPCS | High | Wheelchair, pediatric size, rigid, adjustable, with seating system |
| E1236-HCPCS | High | Wheelchair, pediatric size, folding, adjustable, with seating system |
| E1237-HCPCS | High | Wheelchair, pediatric size, rigid, adjustable, without seating system |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1236. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1236 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.
Bring your top codes (like HCPCS E1236) and we'll show you how you compare in 15 minutes or less.