Insurance & Reimbursement

Your EZ-P™ May Be Covered

Many insurance plans — including Medicaid, Medicare, and private insurers — may reimburse for the EZ-P™ as a wheelchair accessory with a physician's Letter of Medical Necessity. We've made it easy to get started.

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Letter of Medical Necessity Template

Pre-filled PDF — bring to your doctor, get signed, submit to insurance.

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How to Submit for Reimbursement

1

Download the Letter of Medical Necessity template above.
It's pre-filled with all the device details your doctor needs — including the correct billing code, FDA registration status, and patent number.
2

Bring it to your physician, physiatrist, urologist, or occupational therapist.
Ask them to sign and date it — either on the template itself or transferred to their official practice letterhead.
3

Submit the signed letter and your EZ-P™ purchase receipt to your insurer.
Request reimbursement under HCPCS code K0669 (wheelchair accessory, cushion). Your provider may need to request prior authorization on your behalf.
4

Keep copies of everything.
Retain your signed LMN, receipt, and any insurance correspondence. If a claim is denied, you have the right to appeal.

What to Expect

Right now: You can submit for reimbursement under HCPCS K0669 with a signed Letter of Medical Necessity.

~90–120 days: Clarion Care has submitted the EZ-P™ for formal PDAC code verification with CMS. A dedicated billing code will allow broader, more streamlined reimbursement.

After code assignment: We will notify all customers with updated reimbursement instructions and any new codes that may apply.

Keep your receipt: Out-of-pocket costs paid today may be reimbursable retroactively once your insurer processes your claim.

Common Questions

Will my insurance definitely cover this?

Coverage varies by plan, state, and individual eligibility. We cannot guarantee reimbursement. However, many patients with a properly documented Letter of Medical Necessity do receive full or partial reimbursement — especially those with Medicaid, Medicare Advantage, or private insurance that covers durable medical equipment (DME).

What is HCPCS code K0669?

K0669 is a standard billing code for wheelchair cushions or accessories that are awaiting or do not yet have a product-specific billing code. It's the correct code to use while Clarion Care completes the federal PDAC code verification process. Your doctor or OT will know this code.

What doctor should I ask to sign the LMN?

Your primary care physician, physiatrist (rehabilitation physician), urologist, or occupational therapist can all sign a Letter of Medical Necessity. An OT or physiatrist who specializes in spinal cord injury or wheelchair seating is often the most effective option.

My insurance denied the claim. What do I do?

You have the right to appeal any insurance denial. Request a formal denial letter, then file an appeal with your LMN and any supporting clinical documentation. Contact us at info@clarion-care.com — we will provide additional product documentation to support your appeal.

Can I use HSA or FSA funds?

Yes — the EZ-P™ is an FDA-Registered Class I Medical Device, which generally qualifies as an eligible HSA/FSA expense. Consult your plan administrator to confirm eligibility under your specific account terms.

Disclaimer: Reimbursement is not guaranteed and varies by insurance plan, state Medicaid policy, and individual eligibility. Clarion Care, LLC makes no guarantee of coverage or reimbursement. This template is provided as a courtesy to assist patients in pursuing reimbursement through their provider. The EZ-P™ Bladder Management System is an FDA-Registered Class I Medical Device (Patent US12,011,402 B2). It is not FDA-approved. Individual results may vary.

Need Help?

We're here to support you through every step of the reimbursement process.

info@clarion-care.com