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See a sample rate comparisonHCPCS E1296 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Special wheelchair seat height from floor
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Heavy Duty and Special Wheelchairs |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for E1296 |
National average reimbursement for HCPCS E1296 by major payers:
$349.36
$341.71
$339.31
$777.84
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HCPCS E1296
5 of 25 sample ratesHigher to lower in this preview
Ujuka Iloabuchi
Gwinnett Obgyn Associates Of Georgia LLC
$775.54Published rateUpson County Hospital Inc, Upson Regional Medical Center
Upson County Hospital Inc
$342.70Published rateElbert Memorial Hospital
$319.58Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Grady Memorial Hospital Corporation
$218.47Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$23.20Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E1296 vs. Other Heavy Duty and Special Wheelchairs Codes
The HCPCS E1296 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 E1296 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 |
|---|---|---|
| E1295-HCPCS | High | Heavy duty wheelchair, fixed full length arms, elevating legrest |
| E1296-HCPCS | Moderate | Special wheelchair seat height from floor |
| E1297-HCPCS | Low | Special wheelchair seat depth, by upholstery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1296. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1296 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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