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MedicaidBilling CodesMedium impact

ForwardHealth Update 2026-13: ForwardHealth Revises Adaptive Stroller Policy

Wisconsin ForwardHealth·WI · PM&R (Physical Medicine & Rehab), Pediatrics, Neurology·Provider Update
Effective date
Jul 1, 2026
We identified it
Jun 18, 2026
Days to comply
12 days

Summary

ForwardHealth is eliminating the all-inclusive E1035 code for adaptive strollers and requiring providers to use specific HCPCS codes with a UA modifier plus separate line items for accessories. This change aligns with national coding standards and affects prior authorization and billing processes.

Action Required

Before Jul 1, 2026
By July 1, 2026: Billing team must stop using HCPCS code E1035 for adaptive strollers and instead use appropriate wheelchair codes (E1161 or E1231-E1238) with UA modifier for the base unit. Update prior authorization forms and claims to list all accessories as separate line items. Update billing system to apply process type 130 for adaptive stroller PA requests. For PAs approved before July 1, 2026, continue using E1035 per old policy.

Affected Billing Codes

E1035
E1161
E1231
E1232
E1233
E1234
E1235
E1236
E1237
E1238