HCPCS E1238 Fee Schedule

HCPCS E1238 vs. Other Pediatric Wheelchairs Codes

The HCPCS E1238 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 E1238 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.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1238. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the E1238 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.