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See a sample rate comparisonHCPCS E1295 Fee Schedule
Last Verified: September 2026
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.
Heavy duty wheelchair, fixed full length arms, elevating legrest
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Heavy Duty and Special Wheelchairs |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for E1295 |
National average reimbursement for HCPCS E1295 by major payers:
$1,135.26
$760.48
$523.63
$1,729.21
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HCPCS E1295
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$2,342.30Published rateAtl Colorectal Surgery
$1,392.94Published rateSt. Francis Radiologists, LLC
$690.40Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$534.64Published rateJenkins County Hospital LLC, Optim Medical Center - Jenkins
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$78.95Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E1295 vs. Other Heavy Duty and Special Wheelchairs Codes
The HCPCS E1295 code is part of the Durable Medical Equipment services used for Heavy Duty and Special 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 E1295 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 |
|---|---|---|
| E1290-HCPCS | Moderate | Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest |
| E1295-HCPCS | High | Heavy duty wheelchair, fixed full length arms, elevating legrest |
| E1296-HCPCS | Moderate | Special wheelchair seat height from floor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1295. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1295 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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