E1235 — Wheelchair, pediatric size, rigid, adjustable, with seating system
E1235 is a HCPCS Level II code for wheelchair, pediatric size, rigid, adjustable, with seating system. It belongs to the Durable Medical Equipment section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of E1235 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for E1235
- Long descriptor
- Wheelchair, pediatric size, rigid, adjustable, with seating system
- Short descriptor
- Rigid ped wc adjustable
- Added
- January 1, 2003
- BETOS
- D1D
- Pricing indicator
- 36 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Capped rental DME. Price subject to floors and ceilings.
Codes adjacent to E1235
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If E1235 is not quite right, the correct code is very often within a few positions of it.
- E1227Special height arms for wheelchair
- E1228Special back height for wheelchair
- E1229Wheelchair, pediatric size, not otherwise specified
- E1230Power operated vehicle (three or four wheel nonhighway) specify brand name and model number
- E1231Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
- E1232Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system
- E1233Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system
- E1234Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system
- E1236Wheelchair, pediatric size, folding, adjustable, with seating system
- E1237Wheelchair, pediatric size, rigid, adjustable, without seating system
- E1238Wheelchair, pediatric size, folding, adjustable, without seating system
- E1239Power wheelchair, pediatric size, not otherwise specified
- E1240Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest
- E1250Lightweight wheelchair, fixed full length arms, swing away detachable footrest
- E1260Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest
- E1270Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests
Questions about E1235
What is HCPCS code E1235?
E1235 is a HCPCS Level II code for wheelchair, pediatric size, rigid, adjustable, with seating system. It sits in the Durable Medical Equipment section.
Does Medicare cover E1235?
The CMS HCPCS file marks E1235 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.