E1231 HCPCS code: Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
E1231 is the HCPCS Level II code for wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1D — Wheelchairs |
| Added | 2003-01-01 |
| Last action effective | 2009-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A52497: Manual Wheelchair Bases - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A52504: Wheelchair Options/Accessories - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for E1231
- 2003-01-01: E1231 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code E1231?
E1231 is the HCPCS Level II code for wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system. Short descriptor: "Rigid ped w/c tilt-in-space".
Does Medicare cover E1231?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of E1231 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E12 codes
- E1200 — Amputee wheelchair, fixed full length arms, swing away detachable footrest ($105.40–$179.59)
- E1220 — Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
- E1221 — Wheelchair with fixed arm, footrests ($57.56–$87.75)
- E1222 — Wheelchair with fixed arm, elevating legrests ($82.09–$129.73)
- E1223 — Wheelchair with detachable arms, footrests ($89.66–$122.59)
- E1224 — Wheelchair with detachable arms, elevating legrests ($98.31–$139.00)
- E1225 — Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each ($43.15–$70.60)
- E1226 — Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each ($41.94–$1,539.67)
- E1227 — Special height arms for wheelchair ($17.79–$474.54)
- E1228 — Special back height for wheelchair ($33.95–$41.50)
- E1229 — Wheelchair, pediatric size, not otherwise specified
- E1230 — Power operated vehicle (three or four wheel nonhighway) specify brand name and model number ($269.48–$3,830.63)
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Next steps
- Run a reimbursement report for a device billed under E1231
- Watch E1231 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E1231
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.