Crutch HCPCS Codes Explained: E0110 vs. E0117 (and Why It Matters)

A plain-English guide to the crutch billing codes, why E0110 sails through Medicare while E0117 usually does not, and how to use this knowledge to get the crutch you actually want.

Every piece of medical equipment Medicare pays for has a HCPCS code, a short identifier that tells the insurer exactly what it is. For crutches, there are several codes, but two matter most: E0110 and E0117. Which one appears on your provider's order determines whether Medicare pays, how much it pays, and what type of crutch you actually receive.

The crutch codes at a glance

The distinction that matters most

Notice the difference between two codes in particular. E0110, the forearm crutch, is straightforward, standard covered DME. E0117, the articulating spring-assisted underarm crutch, carries special coverage instructions, which in practice means Medicare generally does not reimburse it. The spring-assisted mechanism that makes it easier on the body is precisely the feature Medicare treats as non-standard.

If you have read our Veterans Benefits series, this may surprise you, because it is the reverse of the VA situation. The VA covers E0117 and treats it as standard equipment. Medicare takes the opposite position. Same product, opposite coverage decisions by the two largest payers in the U.S.

Why the code on your order is so powerful

Billing staff and suppliers work from codes, not adjectives. If your provider writes crutches with no code, the supplier fills the order with whatever code fits their default inventory, which is usually the cheapest option. If the order says forearm crutches, HCPCS E0110, the supplier has no ambiguity about what to pull and what to bill.

How to still get a premium model under Medicare

If you want the spring-assisted underarm model that Medicare will not pay for outright, you are not out of options:

• Upgrade with an ABN. The supplier bills the covered base crutch and you pay the difference for the upgraded model. You get the better crutch, Medicare covers its portion of the base.
• Dual eligibility. If you have both Medicare and Medicaid, Medicaid may cover the item after Medicare issues a denial, depending on your state's rules.
• Pay directly. Because the codes that matter most clinically (the forearm models) are inexpensive, many people find the out-of-pocket cost reasonable, especially compared with FSA or HSA funds.

Frequently asked questions

Does Medicare cover HCPCS code E0117?

Generally no. E0117, the articulating spring-assisted underarm crutch, carries special coverage instructions and is usually not reimbursed by Medicare, though some other payers cover it.

What is the HCPCS code for forearm crutches?

E0110 covers a pair of forearm crutches with tips and handgrips, and E0111 covers a single forearm crutch. These are standard covered durable medical equipment under Medicare.

Why did I get standard crutches when I wanted a specific type?

The order was likely filled under a generic code. Asking your provider to specify the crutch type and code on the order prevents the default.

This article is general education, not a guarantee of coverage. Medicare and Medicaid rules change and vary by plan, state, and region. Always confirm coverage and costs with your plan and your supplier before you receive equipment.

Be kind. Be generous. Always pay it forward.

This guide is part of our Medicare Crutch Coverage hub, where you'll find every option for getting crutches covered.