Please monitor the EI website for changes to the Assistive Technology Code Table.
Assistive Technology Equipment
| CODE |
CODE DESCRIPTION |
| A4636 |
Replacement, handgrip, cane, crutch, or walker, each |
| A4637 |
Replacement, tip, cane, crutch, walker, each |
| A9300 |
Exercise equipment, (i.e., therapy ball, roll, bolster, any size) |
| A9900 |
Computer access, software |
| A9900 |
Miscellaneous DME supply, accessory, and/or service component of another HCPCS code (i.e. Weighted vest, any type) |
| A9900 |
Switch activated device |
| A9900 |
Switch, battery adapter |
| A9900 |
Weighted blanket, any size |
| A9900 |
Weights, miscellaneous |
| E0110 |
Crutches, forearm, includes crutches of various materials, adj or fixed, pair, complete |
| E0111 |
Crutch, forearm, includes crutches of various materials, adj or fixed, each, complete |
| E0130 |
Walker, rigid pickup, adjustable/fixed, each |
| E0135 |
Walker, folding (pickup), adj or fixed height |
| E0141 |
Walker, rigid wheeled without seat |
| E0142 |
Rigid walker, wheeled, with seat |
| E0143 |
Folding walker, wheeled, without seat |
| E0144 |
Enclosed, framed folding walker, wheeled with posterior seat |
| E0146 |
Folding walker, wheeled, with seat |
| E0153 |
Platform attachment, forearm crutch, each |
| E0154 |
Platform attachment, walker, each |
| E0155 |
Wheel attachment, rigid pickup walker, per pair |
| E0158 |
Leg extensions for walker, per set of four (4) |
| E0247 |
Tub stool or bench |
| E0248 |
Tub stool or bench |
| E1399 |
Temporary code (feeder seats, positioning chairs) |
| E1399 |
AFO, addition, foot/calf strap, each (therapeutic listening programs) |
| E1399 |
Durable Medical Equipment, NEC |
| E1399 |
Posture control seat for floor sitting and feeding, any size |
| E1399 |
Walker, pelvic stabilizer attachment |
| E1399 |
Wedge, floor therapy |
| E1802 |
Dynamic adjustable forearm, pronation/supination device, includes soft interface material |
| E1902 |
Communication board, non-electronic augmentative or alternative communication device (PECS, eye-comm. board, boardmaker) |
| K0113 |
Trunk support device, vest type, without inner frame, prefabricated, Benik, only |
| K0541 |
Speech generating device, digitized speech, prerecorded messages, <=8 min recording time (Twin talk) |
| K0542 |
Speech generating device, digitized speech, prerecorded messages, >8 minrecording time (Dynavox, Macaw, Step by Step, E-talk) |
| K0544 |
Speech generating device, synthesized speech, permitting multi methods of message formation and multi methods of device access |
| K0546 |
Accessory for speech generating device, mounting system |
| K0547 |
Accessory for speech generating device, NOC (overlay, keyguard) |
| L0120 |
Collar, flexible, nonadjustable (foam collar) |
| L0984 |
Spinal orthosis, protective body sock |
| L1500 |
THKAO, mobility frame (Newington, parapodium types) |
| L1510 |
THKAO, standing frame, with or without tray and accessories |
| L1520 |
THKAO, swivel walker |
| L1600 |
HO, abduction control of hip joints, flexible, Frejka type with cover, prefabricated, F&A |
| L1610 |
HO, abduction control of hip joints, flexible, (Frejka cover only), prefabricated, F&A |
| L1620 |
HO, abduction control of hip joints, semi-flexible, (Pavlik harness), prefabricated, F&A |
| L1630 |
HO, abduction control of hip joints, semi-flexible, (Von Rosen type), custom fabricated |
| L1640 |
HO, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated |
| L1650 |
HO, abduction control of hip joints, static, adjustable (Ilfled type), prefabricated, F&A |
| L1660 |
HO, abduction control of hip joints, static, plastic, prefabricated, F&A |
| L1680 |
HO, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (Ranch hip action type), custom fabricated |
| L1690 |
Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, F&A (SWASH) |
| L1800 |
KO, elastic with stays, prefabricated, F&A |
| L1810 |
KO, elastic with joints, prefabricated, F&A |
| L1830 |
KO, immobilizer, canvas longitudinal, prefabricated, F&A |
| L1860 |
KO, modification of supracondylar prosthetic socket, custom fabricated |
| L1901 |
Ankle orthosis, elastic, prefabricated, F&A (e.g., neoprene, lycra) |
| L1902 |
AFO, ankle gauntlet, prefabricated, F&A |
| L1904 |
AFO, molded ankle gauntlet, custom fabricated |
| L1920 |
AFO, single upright with static or adjustable stop, custom fabricated |
| L1930 |
AFO Prefabricated |
| L1930 |
AFO, plastic or other material, prefabricated, F&A |
| L1940 |
AFO, plastic or other material, custom fabricated |
| L1940 |
SMO |
| L1945 |
AFO, molded to patient model, plastic, rigid anterior tibial section (floor reaction), custom fabricated |
| L1950 |
AFO, spiral, (IRM type), plastic, custom fabricated |
| L1960 |
AFO, posterior solid ankle, plastic, custom fabricated |
| L1970 |
AFO, plastic, with ankle joint, custom fabricated |
| L1980 |
AFO, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar "BK" orthosis), custom fabricated |
| L1990 |
AFO, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar "BK" orthosis), custom fabricated |
| L2000 |
KAFO, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar "AK" orthosis), custom fabricated |
| L2010 |
KAFO, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar "AK" orthosis), without knee joint, custom fabricated |
| L2020 |
KAFO, double upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar "AK" orthosis), custom fabricated |
| L2030 |
KAFO, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar "AK" orthosis), without knee joint, custom fabricated |
| L2035 |
KAFO, full plastic, static (pediatric size), prefabricated, F&A |
| L2036 |
KAFO, full plastic, double upright, free knee, custom fabricated |
| L2037 |
KAFO, full plastic, single upright, free knee, custom fabricated |
| L2038 |
KAFO, full plastic, without knee joint, multiaxis ankle, (Lively orthosis or equal), custom fabricated |
| L2040 |
HKAFO, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated |
| L2050 |
HKAFO, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated |
| L2060 |
HKAFO, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/belt, custom fabricated |
| L2070 |
HKAFO, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated |
| L2080 |
HKAFO, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated |
| L2090 |
HKAFO, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/belt, custom fabricated |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
| L2210 |
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
| L2230 |
Addition to lower extremity, split flat caliper stirrups and plate attachment |
| L2240 |
Addition to lower extremity round caliper and plate attachment |
| L2250 |
Addition to lower extremity, foot plate, molded to patient model, stirrup attachment |
| L2260 |
Addition to lower extremity, reinforced solid stirrup |
| L2265 |
Addition to lower extremity, long tongue stirrup |
| L2270 |
Addition to lower extremity, varus/valgus correction ("t") strap, padded/lined or malleolus pad |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
| L2280 |
Addition to lower extremity, molded inner boot |
| L2300 |
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable |
| L2310 |
Addition to lower extremity, abduction bar, straight |
| L2320 |
Addition to lower extremity, nonmolded lacer |
| L2330 |
Addition to lower extremity, lacer molded to patient model |
| L2335 |
Addition to lower extremity, anterior swing band |
| L2340 |
Addition to lower extremity, pretibial shell, molded to patient model |
| L2350 |
Addition to lower extremity, prosthetic type, (BK) socket, molded to patient model, (used for "PTB," "AFO" orthosis) |
| L2360 |
Addition to lower extremity, extended steel shank |
| L2370 |
Addition to lower extremity, Patten bottom |
| L2375 |
Addition to lower extremity, torsion control, ankle joint and half solid stirrup |
| L2380 |
Addition to lower extremity, torsion control, straight knee joint, each joint |
| L2405 |
Addition to knee joint, drop lock, each joint |
| L2415 |
Addition to knee lock with integrated release mechanism (ball, cable, or equal), any material, each joint |
| L2425 |
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint |
| L2430 |
Addition to knee joint, ratchet lock for active and progressive knee extension, each joint |
| L2435 |
Addition to knee joint, polycentric joint, each joint |
| L2580 |
Addition to lower extremity, pelvic control, pelvic sling |
| L2600 |
Addition to lower extremity, pelvic control, hip joint, Clevis type, or thrust bearing, free, each |
| L2622 |
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each |
| L2624 |
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each |
| L2627 |
Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables |
| L2628 |
Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
| L2640 |
Addition to lower extremity, pelvic control, band and belt, bilateral |
| L2650 |
Addition to lower extremity, pelvic and thoracic control, gluteal pad, each |
| L2660 |
Addition to lower extremity, thoracic control, thoracic band |
| L2670 |
Addition to lower extremity, thoracic control, paraspinal uprights |
| L2680 |
Addition to lower extremity, thoracic control, lateral support uprights |
| L2760 |
Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth) |
| L2768 |
Orthotic side bar disconnect device, per bar |
| L2770 |
Addition to lower extremity orthosis, any material, per bar or joint |
| L2785 |
Addition to lower extremity orthosis, drop lock retainer, each |
| L2795 |
Addition to lower extremity orthosis, knee control, full kneecap |
| L2800 |
Addition to lower extremity orthosis, knee control, kneecap, medial or lateral pull |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
| L2830 |
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
| L2860 |
Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism, each |
| L2999 |
Lower extremity orthosis, NOS |
| L3000 |
Foot insert, removable molded to patient model, "UCB" type, berkely shell, each |
| L3001 |
Foot insert, removable, molded to patient, Spenco, each |
| L3002 |
Foot insert, removable, molded to patient model, Plastazote or equal, each |
| L3003 |
Foot insert, removable, molded to patient model, silicone gel, each |
| L3010 |
Foot insert, removable, molded to patient model, longitudinal arch support, each |
| L3020 |
Foot insert, removable, molded to patient model, longitudinal/metatarsal support, each |
| L3030 |
Foot insert, removable, formed to patient foot, each |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, ea |
| L3050 |
Foot, arch support, removable, premolded, metatarsal, each |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/metatarsal, each |
| L3070 |
Foot, arch support, nonremovable, attached to shoe, longitudinal, each |
| L3080 |
Foot, arch support, nonremovable, attached to shoe, metatarsal, each |
| L3090 |
Foot, arch support, nonremovable, attached to shoe, longitudinal/metatarsal, each |
| L3140 |
Foot, abduction rotation bar, including shoes |
| L3150 |
Foot, abduction rotation bar, without shoes |
| L3170 |
Foot, plastic heel stabilizer |
| L3201 |
Orthopedic shoe, oxford with supinator or pronator, infant |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
| L3204 |
Orthopedic shoe, hightop with supinator or pronator, infant |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
| L3212 |
Benesch boot, pair infant |
| L3213 |
Benesch boot, pair child |
| L3257 |
Orthopedic footwear, additional charge for split size |
| L3300 |
Lift, elevation, heel tapered to metatarsals, per inch |
| L3310 |
Lift, elevation, heel and sole, neoprene, per inch |
| L3320 |
Lift, elevation, heel and sole, cork, per inch |
| L3332 |
Lift, elevation, inside shoe, tapered, up to one-half inch |
| L3350 |
Heel wedge |
| L3380 |
Clubfoot wedge |
| L3580 |
Orthopedic shoe addition, convert instep to velcro closure |
| L3700 |
EO, elastic with stays, prefabricated, F&A |
| L3701 |
Elbow orthosis, elastic, prefabricated F&A, (e.g., neoprene, Lycra) |
| L3710 |
EO, elastic with metal joints, prefabricated F&A |
| L3720 |
EO, double upright with forearm/arm cuffs, free motion, custom fabricated |
| L3730 |
EO, double upright with forearm/arm cuffs, extension/flexion assist, custom fabricated |
| L3740 |
EO, double upright with forearm/arm cuffs, free motion, custom fabricated |
| L3760 |
Elbow orthosis, with adjustable position locking joint(s), prefabricated, F&A, any type |
| L3762 |
Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, F&A |
| L3800 |
WHFO, short opponens, no attachments, custom fabricated |
| L3805 |
WHFO, long opponens, no attachments, custom fabricated |
| L3807 |
WHFO, without joints, prefabricated, F&A, any type |
| L3810 |
WHFO, addition to short and long opponens, thumb abduction ("C") bar |
| L3890 |
Addition to upper extremity joint, wrist or elbw, concentric adjustable torsion style mechanism, each |
| L3906 |
WHO, wrist gauntlet, molded to patient model, custom fabricated |
| L3907 |
WHFO, wrist gauntlet with thumb spica, molded to patient model, custom fabricated |
| L3908 |
WHO, wrist extension control cock-up, non-molded, prefabricated, F&A |
| L3909 |
Wrist orthosis, elastic, prefabricated, F&A (e.g., neoprene, Lycra |
| L3911 |
Wrist hand finger orthosis, elastic, prefabricated, F&A (e.g., neoprene, Lycra) |
| L3912 |
HFO, flexion glove with elastic finger control, prefabricated, F&A |
| L3914 |
WHO, wrist extension cock-up, prefabricated, F&A |
| L3923 |
HFO, without joints, prefabricated, F&A |
| L3936 |
WHFO, Palmer, prefabricated, F&A |
| L3938 |
WHFO, dorsal wrist, prefabricated, F&A |
| L3946 |
HFO, composite+F164 elastic, prefabricated, F&A |
| L3956 |
Addition of joint to upper extremity orthosis, any material; per joint |
| L3999 |
Upper limb orthosis, NOS |
| L4210 |
Repair of orthotic device, repair or replace minor parts |
| L4392 |
Replacement soft interface material, static AFO |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding, and other supplies |
| S5199 |
Adaptive, utensil, feeding |
| S5199 |
Adaptive, cup, nosey |
| S5199 |
Personal care item, NOS, each |
| S8470 |
Stander, positioning device |
| V5014 |
Hearing aid, repairs, over $100 |
| V5014 |
Repair/modification of a hearing aid |
| V5060 |
Hearing aid, monaural, behind the ear |
| V5140 |
Hearing aid, binaural, behind the ear |
| V5150 |
Hearing aid, binaural, glasses |
| V5160 |
Hearing aid dispensing fee, binaural |
| V5241 |
Hearing aid dispensing fee, monaural |
| V5267 |
Hearing aid, pediatric care kit |
| V5264 |
Hearing aid ear mold/insert, not disposable, any type |
| V5266 |
Battery for use in hearing aid |
| V5266 |
Hearing aid, battery, silver, any size, each |
| V5267 |
Hearing aid supplies/accessories |
| V5267 |
Hearing aid, alligator clip |
| V5267 |
Hearing aid, Replacement cord |
| V5336 |
Repair/modification of augmentative communication system or device |
