HCPCS Coding & Medicare Coverage
Both the APK2, the SofTech are coded E2609 for Medicare reimbursement and private insurance reimbursement, and you do not need a doctor’s prescription to order and purchase any wheelchair cushion directly from Aquila but you will need a prescription to run through Medicare or other insurance. Below is the coverage policy information for any Aquila custom wheelchair cushion system.
We have recently heard from DME companies that the most Medicare will pay towards a SofTech is a few hundred dollars and that the process can take up to a year to come through.
Private insurance and/or workers’ compensation may offer a different outcome.