2025 HCPCS code E0635
(Active) Effective Date: N/A Revision Date: N/A Durable Medical Equipment (DME) - Patient Lifts and Support Systems E - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Feed
Supply of an electric patient lift with seat or sling and accessories.
Modifiers may be necessary to indicate specific circumstances (e.g., multiple lifts ordered, rental versus purchase). Consult payer-specific guidelines for applicable modifiers.
Medicare and other payers require evidence that the patient lift is reasonable and necessary for the patient's condition and prevents bed confinement. The need for the lift should be directly supported by the patient's clinical presentation.Without the lift, the patient must demonstrate a confinement to bed and the need for periodic movement for improvement.
The physician or qualified healthcare provider assesses the patient's need for a patient lift and orders the equipment. The DME supplier provides and bills for the equipment.
In simple words: This code covers the cost of an electric lift used to help move patients from their bed to a chair, wheelchair, or toilet. It's only covered if the patient needs help from two or more people to move and would otherwise be stuck in bed.
HCPCS code E0635 represents the supply of an electric patient lift, inclusive of accessories such as a seat, sling, straps, or belts.This equipment facilitates patient transfers between bed, wheelchair, commode, chair, or shower. It may also assist with supported walking and weight-bearing exercises. Medical necessity is established when the patient cannot perform these transfers independently and requires at least two caregivers without the lift, resulting in bed confinement.Periodic mobility is crucial for patient improvement.Provider documentation must detail the patient encounter and the condition necessitating the DME order.
Example 1: A 75-year-old post-stroke patient with significant weakness requires assistance for transfers. An electric patient lift (E0635) is medically necessary to prevent bed confinement and promote mobility., A 90-year-old patient with severe osteoarthritis cannot perform transfers without assistance. The electric patient lift (E0635) facilitates safe and efficient transfers, preventing falls and promoting independence in daily activities., A morbidly obese patient with limited mobility requires assistance for transfers. A heavy-duty electric patient lift (E0635, possibly with specific modifiers), tailored to the patient's weight and size, is medically necessary to prevent injury and ensure safe transfers.
Detailed medical record documentation should include:
** The selection of the appropriate code depends on the specific type and features of the lift.Always verify coverage and payment policies with the specific payer before submitting claims.
- Payment Status: Active (subject to medical necessity and payer policies)
- Modifier TC rule: The TC modifier (technical component) is generally not applicable to this supply code.
- Fee Schedule: Historical fee schedules vary by payer and date. Consult relevant fee schedules for the specific time period.
- Specialties:Physical Medicine and Rehabilitation, Geriatrics, Occupational Therapy, Nursing, Home Health
- Place of Service:Home, Skilled Nursing Facility, Inpatient Hospital (in some cases)