2025 HCPCS code E0636
(Active) Effective Date: N/A Revision Date: N/A Durable Medical Equipment (DME) - Patient Lifts E0621-E0642 Patient Lifts and Support Systems Feed
Supply of a multipositional patient support system with an integrated lift and patient-accessible controls.
Modifiers may apply depending on circumstances (e.g., KX for meeting medical necessity criteria, others as needed per payer policies).
The patient must be unable to perform transfers independently and require assistance from at least two caregivers.The use of the lift must be necessary to prevent bed confinement, promote mobility, and reduce the risk of falls and injury.
The ordering physician is responsible for determining the medical necessity of the DME and documenting the patient's condition requiring its use.The supplier is responsible for providing the equipment and ensuring proper functionality.
In simple words: This code covers the cost of a special lift that helps move patients from their bed to other places like a wheelchair or toilet.It's only covered if the patient can't move themselves and needs help from two or more people.The doctor must explain why the lift is needed.
This HCPCS code, E0636, represents the supply of a single, multipositional patient support system.This all-in-one unit assists with patient transfers and movements, aiding caregivers in turning, lifting, and transferring the patient between bed, wheelchair, commode, chair, or shower. The system includes a built-in lift with patient-operable controls. Medical necessity is established when the patient cannot perform these transfers independently and requires at least two caregivers. Without the lift, the patient would be bed-bound; periodic movement is essential for improvement.The provider must document the direct encounter and the condition necessitating the DME order.
Example 1: A 78-year-old post-stroke patient with significant right-sided weakness requires assistance for all transfers.A multipositional patient support system (E0636) is medically necessary to prevent bedsores and promote mobility., An obese 55-year-old patient with severe osteoarthritis is unable to transfer from bed to chair without assistance from two or more caregivers.E0636 is medically necessary to improve the patient's quality of life and prevent injury to the patient and caregivers., A 90-year-old patient with severe dementia and multiple comorbidities requires assistance with transfers. The patient is at high risk for falls.Use of E0636 is considered medically necessary to ensure safe transfers and prevent falls.
* Detailed medical history and physical examination findings supporting the need for a patient lift.* Documentation of the patient's inability to perform transfers independently.* Assessment of the risk of falls or injury without the lift.* Description of the patient's functional limitations and need for assistance with transfers.* Explanation of how the multipositional patient support system will improve the patient's functional status and quality of life.* Physician's order specifying the type of equipment and indicating medical necessity.
** Always verify payer-specific policies and coverage criteria before billing. Ensure accurate documentation of medical necessity to support claims.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a supply code.
- Fee Schedule: Historical fee schedule data is not available in the provided sources; refer to CMS data for the most accurate information.
- Specialties:Physical Medicine and Rehabilitation, Occupational Therapy, Geriatric Medicine, Nursing
- Place of Service:Home, Skilled Nursing Facility, Assisted Living Facility, Inpatient Hospital, Outpatient Hospital