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Alberta Health
AADL Approved Product List - Seating Benefits
Pricing effective April 1, 2014
Revision History
Updates to Catalogue
Numbers (see inside)
4/1/2014
Updated: Approved Seating
Manufacturers
4/1/2014
Updated: APL Format
4/1/2014
© 2013 Government of
Alberta April 1, 2014
Alberta Health - Professional Services and Health Benefits
AADL Seating Approved Product List
General Information for Seating Benefits
AADL clients are eligible for one seating system. If clients have more than one mobility base and the components
cannot be transferred, the client is responsible for the costs of the duplicate components.
Benefits listed on the AADL Seating Approved Product List can only be authorized by designated AADL Seating
Authorizers.
Two levels of Seating Clinics:
Level I Seating Clinics
Provide commercially available seating components in conjunction with an AADL Seating Vendor who has a
Commercial Seating Technician.
Level II Seating Clinics
Provide custom-fabricated seating components in conjunction with AADL Seating Vendors who has a Adaptive
Seating Technician.
The prices listed in the AADL Seating Approved Product List are as follows:
Level I
The price is the manufacturer retail price less a 5% discount.
Level II
The price represents the combined cost for materials and labour.
Some Level I catalogue numbers are designated as generic catalogue numbers. Generic catalogue numbers are a
benchmark pricing model. Each catalogue number has a price maximum. Seating vendors must provide an item that
meets the description at or below the price maximum. The price maximum is based on the manufacturer's retail price,
less a 5% discount. Seating vendors must apply a 5% discount when using the generic catalogue numbers. Costs over
the AADL price maximum are considered an upgrade and are the client's responsibility.
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 2 of 36
APL X-1
Alberta Health - Professional Services and Health Benefits
AADL Seating Approved Product List
General Catalogue Number Information
These catalogue numbers are used to provide commerically-available seating components for which there is no
specific catalogue number. The equipment provided using a generic catalogue number must meet the following
criteria:
 Product must be available from an AADL Approved Seating Manufacturer.
 Product must meet the AADL Commercial Seating Product Minimum Standards.
AADL Commercial Seating Product Minimum Standards
Warranty – The manufacturer must warrant that the product will be free from defects in material and
workmanship for the below noted minimum years from the date the equipment was purchased:
 Bases: 2 years
 Lateral Supports: 2 years
 Headrests: 2 years
 Pommels: 1 year
 Straps/Belts: 1 year
 Bolsters, Adductors/Abductors: 1 year
 Wedges: 1 year
 Foot/Leg Supportss: 1 year
 Arm/Shoulder Supports: 1 year
 Trays: 1 year
 Backs: 2 years
Equipment Limitations – Equipment must have been in production for a minimum of one year in the North
American market.
Liability Insurance – Equipment provided must have a minimum two million dollars comprehensive general
liability insurance provided by the manufacturer.
Fire Retardancy – Materials must meet at least the California 117 Fire Retardancy Standard.
Pricing Example: Generic Catalogue Number Y-Belt
Manufacturer’s retail price = $85
Pricing procedure: $85 – 5% = $80.75
AADL Maximum Contribution = $80.75 (for cost-share exempt clients)
Cost-Share Client portion (25%) = $80.75 x 25% = $20.19
AADL portion for cost-share client = $80.75 x 75% = $60.56
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 3 of 36
APL X-2
Alberta Health - Professional Services and Health Benefits
AADL Seating Approved Product List
AADL Approved Seating Manufacturers
Manufacturer
Manufacturer Representative
Contact Email
Bodypoint
Brandon Strap
bstrap4763@gmail.com
Tom Corbett
Tcorbett@invacare.com
Invacare
Power Plus Mobility
Jason Mohan
jason@powerplusmobility.com
Brandon Strap
bstrap4763@gmail.com
Braden Hirsch
15@49bespoke.com
ROHO
Varilite
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 4 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
01. Headrests, Neckrests, Hardware & Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X062
$189.70 Max. Each
X331
$46.46 Max. Each
X045
$186.73 Max. Each
Generic Commercial Seating Component - Use generic pricing method
Adaptor Kit or Mounting Plate for
Headrest/Neckrests
Clamp
To mount headrest or other seating component
Hardware for Headrest/Neckrest
1 Kit or Plate Per 4 Years
2 Clamps Per 4 Years
1 Headrest Hardware Per 4
Years
This catalogue number is only for the hardware for a headrest, combine with X015 if required.
Headrest/Neckrest
Headrest with Lateral Support
1 Headrest Per 4 Years
X035
$171.91 Max. Each
X040
Prior Approval
No hardware included, combine with X045 if required.
Specialized Headrest
Includes hardward, cannot be combined with X045. Prior Approval. Submit spec sheets/pricing and clinical
rationale to AADL.
Standard Headrest or Neckrest
X015
$153.14 Max. Each
X688
$82.76 Each
X687
$82.76 Each
X690
$174.41 Each
X436
$173.85 Each
X435
$337.25 Each
X437
$52.25 Each
X442
$199.50 Each
I202
$38.95 Each
X486
$285.00 Each
No hardware included, combine with X045 if required.
Daher
Headrest
Combination Headrest HC100
1 Headrest Per 4 Years
Large Headrest HL100
Headrest Hardware
WS10
1 Hardware Per 4 Years
Future Mobility
Headrest
Multi-axial Headrest - On Chair
1 Headrest Per 4 Years
Single Multi-axial Headrest, large foam pad and cover (no wings) includes
hardware - Off Chair
Headrest Extension
Multi-axial Headrest Horizontal Extension
1 Extension Per 4 Years
Headrest Hardware
Multi-axial Universal Hardware
1 Hardware Per 4 Years
Invacare
Elite Back Headrest Adaptor
1 Adaptor Per 4 Years
Jay
Headrest
Jay 3 AXYS Mount
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Headrest Per 4 Years
Page 5 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
01. Headrests, Neckrests, Hardware & Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X487
$522.50 Each
X491
$57.00 Each
X463
$342.00 Each
X467
$95.00 Each
X522
$171.91 Each
Soft Headrest 430H2
X391
$153.14 Each
Styles Lg/Sm 430C1 = 1-7/3-7, or 430H1 = 1-7/3-7
X069
$105.72 Each
X868
$189.70 Each
X386
$196.61 Each
X078
$186.73 Each
Jay
Headrest
Jay 3 COBRA Mount
1 Headrest Per 4 Years
Headrest mount
Jay 3 back universal
1 Headrest Mount Per 4 Years
Maple Leaf Wheelchair
Headrest
Mounting plate not included
Headrest Mounting Plate
1 Headrest Per 4 Years
1 Plate Per 4 Years
Ottobock
Headrest
Lateral Control Headrest 430C2 1-7/3-7
Headrest Adpator Kit
476D52 SK010/015/020/025/060/065
1 Headrest Per 4 Years
1 Adaptor Kit Per 4 Years
1 Hardware Per 4 Years
Headrest Hardware
Gooseneck Mounting Kit 476L52-SK030 or Straight Mounting Kit 476L52-SK035
Multi-Axis Offset or Multi-Axis Straight
Mounted to wheelchair insert, can be used for neckrest also 476L52-SK020/025/010/015
Headrest Hardware Adaptor Kit
1 Adaptor Kit Per 4 Years
X079
$227.24 Each
Mounted to wheelchair uprights to back tubes of W/C using STS clamps 476D52-SK020/030/035/040/045/05
Headrest Hardware Clamp
For any back (477152=SK039)
1 Clamp Per 4 Years
STS Clamps
477D52/434H1
2 Clamps Per 4 Years
X969
$47.65 Each
X387
$46.46 Each
I210
Prior Approval
X364
$186.20 Each
X365
$376.20 Each
To attach headrest hardware
Stealth
Stealth i2i Headrest
1 Headrest Per 4 Years
Prior Approval. Submit spec sheet/pricing and clinical rationale to AADL.
Western Home Medical
Cane Mount Bracket
Bracket Only
Including Aspen2 Headrest
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Bracket Per 4 Years
Page 6 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
01. Headrests, Neckrests, Hardware & Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X196
$304.00 Each
Adjustable offset. Aspen1 & Aspen2
X195
$333.45 Each
With multi-axle hardware 5470 - Aspen1
X428
$337.25 Each
With multi-axle hardware 5471 - Aspen2
X429
$337.25 Each
Western Home Medical
Headrest
Adjustable chair mount, Oxford 1 system
1 Headrest Per 4 Years
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X348
$177.93 Each
X606
$188.90 Each
1 Headrest Per 4 Years
Headrest
Headrest with lateral support, wood rigid shell, foam and covering with movable
lateral extension
X003
$352.33 Each
With lateral support, kydex shell, foam and covering with movable lateral extension
X378
$508.91 Each
X072
$105.93 Each
X449
$426.76 Each
X010
$361.89 Each
Custom-Made
Hardware for Custom-Made Headrest
Multi-axial
1 Hardware Per 4 Years
Standard
Headrest Cover (replacement only)
Removable Cover
1 Cover Per 12 Months
For replacement only
Headrest/Neckrest
Rigid kydex shell, foam and covering, occipital support
Rigid wood shell, foam and covering, occipital support
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Headrest Per 4 Years
Page 7 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
02. Straps, Belts & Kits
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
1 Strap Per Leg Per 12 Months
Calf Strap or H Strap
Posterior support for bilateral/positioning of the lower legs.
X065
$92.15 Max. Each
1 Chest Strap Per 12 Months
Chest Strap
Chest Harness, Butterfly Strap, or H-Strap, for torso/thoracic positioning
X225
$120.00 Max. Each
X954
$28.50 Max. Each
X107
$24.70 Max. Each
X070
$92.63 Max. Each
X227
$156.75 Max. Each
X971
$185.25 Per Pair
X498
$97.85 Each
X393
$192.85 Each
X664
$104.50 Each
X427
$156.75 Each
X426
$127.30 Each
X414
$85.50 Each
X691
$86.64 Each
X347
$99.23 Each
X420
$173.85 Each
X484
$189.05 Each
Generic Commercial Seating Component - Use generic pricing method
1 Footstrap Per Foot Per 12
Months
Footstrap/Toe Loop
Transverse Strap for positioning of foot
1 Kit Per 12 Months
Hardware Kit for Belt
Heel Loop/Ankle Strap
Strapping mechanism to secure ankle/foot.
2 Per 12 Months
Pelvic Strap
Y or K Strap/Belt, for pelvic positioning.
1 Per 12 Months
Bodypoint
Ankle Huggers
Medium/large
1 Pair Footstraps Per 12 Months
Chest Strap
MonoFlex anterior trunk support
1 Chest Strap Per 12 Months
Stayflex Anterior Trunk Support - with or without zipper
1 Leg Strap Per 2 Years
Leg Harness
HB 602/603/604
1 Pelvic Belt Per 12 Months
Pelvic Belt
4 point centre pull - small/med/large HB501CHB502C HB503C
Padded Hip Belt 2 point centre pull - small/med HB104C
Universal Strap
1 Strap Per 2 Years
Daher
Chest Harness
Small, medium, large
1 Chest Strap Per 4 Years
Pelvic Belt
K/Y Belt - 2"
1 Pelvic Belt Per 12 Months
Jay
AES Structured Y Shoulder Strap
Chest Strap
Jay 3 Chest Straps/Harnesses
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Trunk Support Per 12 Months
1 Chest Strap Per 12 Months
Page 8 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
02. Straps, Belts & Kits
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X405
$283.56 Each
X998
$66.50 Each
X962
$106.88 Each
X948
$47.50 Each
K Belt, padded/black webbing & hardware N4.027
X944
$114.00 Each
K Belt, padded/black webbing N4.028
X945
$109.25 Each
Y Belt with safety/black webbing & hardware N4.021
X938
$114.00 Each
X445
$74.58 Each
X590
$131.10 Each
Lecky
1 Chest Strap Per 12 Months
Waistcoat
Nighthawk
Chest Strap
Female medium/large, male small/med/large
1 Chest Strap Per 12 Months
Padded Chest Strap N4.037
Pelvic Belt
Black webbing N4.031
1 Pelvic Strap Per 12 Months
Western Home Medical
1 Chest Strap Per 12 Months
Chest Strap
Butterfly Shoulder Harness - Small, small slim, med., med. slim, large, large slim
Hip Belt
Padded hip belt dual rear pulll #5035
1 Pelvic Strap Per 12 Months
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X109
$96.02 Each
X119
$96.03 Each
X117
$96.02 Each
X038
$104.29 Each
X113
$208.50 Each
Horizontal strap to assist upper trunk control
X041
$102.26 Each
H-Strap, to assist upper trunk control.
X031
$164.42 Each
V-Strap, to assist upper trunk control
X111
$164.42 Each
X106
$110.81 Each
Custom-Made
Abduction Strap
1 Strap Per Leg Per 12 Months
Arm Strap
To secure arm
1 Strap Per Arm Per 12 Months
Axilia Strap
Over-the-shoulder strap
1 Strap Per Arm Per 12 Months
Calf Strap or H Strap
Chest Strap
Butterfly Chest Strap
1 Calf Strap Per Leg Per 12
Months
1 Chest Strap Per 12 Months
To assist upper trunk control
Footstrap/Toe Loop
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Strap Per Foot Per 12 Months
Page 9 of 36
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AADL Seating Approved Product List
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02. Straps, Belts & Kits
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X073
$119.11 Each
X379
$117.18 Each
X033
$143.50 Each
X042
$110.81 Each
X044
$101.90 Each
Custom-Made
Halo Strap or Fitted Head Strap
Attached to headrest
Padded option to strap
1 Halo Strap Per 12 Months
1 Padded Option Per Strap Per
12 Months
Clients are eligible for a maximum quantity of 3.
Pelvic Strap
Basic Y-Strap
1 Pelvic Strap Per 12 Months
Strap of webbing including closure
Safety Strap
To secure insert to mobility base
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Safety Strap Per 2 Years
Page 10 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
03. Hooks, Brackets, Clips, Clamps & Links
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X331
$46.46 Max. Each
X634
$26.30 Max. Each
X108
$60.08 Max. Each
X635
$14.90 Max. Each
X138
$34.63 Max. Each
X505
$46.07 Max. Each
X110
$215.65 Max. Per
Pair
X193
$180.50 Per Pair
I227
$142.50 Per Pair
X192
$142.50 Per Pair
X878
$81.17 Per Pair
Generic Commercial Seating Component - Use generic pricing method
Clamp
To mount headrest or other seating component
Drop Base Mount Clips
Growth Bracket/Hardware
2 Clamps Per 4 Years
4 Per Back and Per Base Per 4
Years
1 Growth Bracket Per 4 Years
4 Hooks Per Back and Per Base
Per 4 Years
Twist Release (antigravity hooks), quantity 4 for base, and quantity 4 for back
Hooks
Locking Suspension Hook (L/R)
Prefab component locks, insert to W/C
Sliding 90 degree bracket
Spacer Hardware
4 Hooks Per 3 Years
1 Sliding Bracket Per 3 Years
1 Pair Per 4 Years
Future Mobility
Back Mounting Brackets
Bariatric
1 Pair Per 4 Years
To transfer the back to 2nd W/C
Lunar Back Brackets
For second wheelchair
Standard
To transfer the back to 2nd W/C
Invacare
2 Pairs of Hooks Per 3 Years
Antigravity Hooks
Quick Release Rail Clamp (anti-gravity hooks) 1063327
This is for replacement only. It is included with Invacare Ultimate Base and Comfortmate Base.
Twist Release (antigravity hooks) for Ultimate curved/Personal backs cane clamp
1063331/332
X615
$159.60 Per Pair
X451
$268.85 Per Pair
X452
$381.90 Per Pair
X665
$215.65 Per Pair
This is for replacement only.
Back Mounting Brackets
Matrx PB Brackets
1 Pair Per 4 Years
To transfer back to 2nd W/C
Matrx PB Brackets - heavy duty
To transfer back to 2nd W/C.
Fixed Spacer Hardware
For Elite backs
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Pair of Spacers Per 4 Years
Page 11 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
03. Hooks, Brackets, Clips, Clamps & Links
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X798
$60.08 Each
X907
$32.49 Each
Invacare
Growth Bracket
5500043
1 Growth Bracket Per 4 Years
Included with KSS. This is for replacement only.
Hooks
Drop Hooks 1063290-95
4 Hooks Per 3 Years
This is for replacement only. It is included with Invacare Ultimate Base and Comfortmate Base.
Drop Hooks for curved back 1063318 (1")
X616
$19.00 Each
1 Pair Per 4 Years
Back Mounting Brackets
For Jay 2, Jay 2 Deep, Jay Care Back - bottom universal post bracket 680C D395
X685
$89.30 Per Pair
For Jay 2, Jay 2 Deep, Jay Care Back - top quick release 1/4 turn bracket 681C
X669
$42.75 Per Pair
X490
$281.20 Per Pair
I216
$180.50 Per Pair
X392
$185.25 Per Pair
X457
$197.60 Per Pair
Each. This is for replacement only.
Jay
To transfer back to 2nd W/C
Jay 3 back hardware
To transfer back to 2nd W/C
nxt
Back Mounting Brackets
Back Brackets
1 Pair Per 4 Years
To transfer back to 2nd W/C
Ottobock
Back Mounting Brackets
Backrest Hardware
1 Pair Per 4 Years
To transfer back to 2nd W/C
Pride Mobility
Back Mounting Brackets
Synergy Shape Back Hardware
1 Pair Per 4 Years
To transfer back to 2nd W/C
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 12 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
04. Lateral Supports, Hardware & Pads
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X214
$217.55 Max. Each
X652
$104.50 Each
X649
$114.95 Each
X607
$435.10 Per Pair
X485
$266.00 Per Pair
X911
$46.46 Each
X812
$118.56 Each
X713
$117.57 Each
Generic Commercial Seating Component - Use generic pricing method
1 Lateral Per Side Per 4 Years
Thoracic Lateral
Hardware and pad
Invacare
Matrx Elite Thoracic Lateral
Off-Set
1 Lateral Per Side Per 4 Years
Rigid
Jay
Jay 2 Thoracic Laterals
Swing-Away
1 Pair of Laterals Per 4 Years
Jay 3 Thoracic Laterals
Fixed Laterals
1 Pair of Laterals Per 4 Years
Ottobock
1 Clamp Per Side Per 4 Years
OB STS Clamp
434H1=1
UPGRADE
1 Lateral Pad Per Side Per 4
Years
OB STS Pad
Large/med/small 434P1
STS Hardware Rod Assembly
1 Support Hardware Per Side
Per 4 Years
434F1
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X017
$164.39 Each
X473
$212.65 Each
X349
$349.95 Each
Custom-Made
Lateral Thoracic Support
Lateral Support, rigid support, foam and covering
1 Lateral Per Side Per 4 Years
Lateral Thoracic Support
Rigid support, foam and covering-kydex curved
1 Lateral Per Side Per 4 Years
Swing-Away
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
05. Hip Bolsters
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X112
$74.10 Max. Each
X198
$74.10 Each
Generic Commercial Seating Component - Use generic pricing method
Lateral Pelvic Support/Hip Bolster
1 Support Per Leg Per 3 Years
Western Home Medical
1 Bolster Per Side Per 3 Years
Side Bolster
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X131
$208.15 Each
Custom-Made
Hip Bolster
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Bolster Per Side Per 3 Years
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06. Wedges, Pommels, Abduction & Adduction
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X114
$142.50 Max. Each
X118
$50.35 Max. Each
X577
$378.10 Max. Each
X115
$124.45 Max. Each
X116
$49.40 Max. Each
X308
$50.35 Each
X306
$50.35 Per Pair
Adductor 2" B113J or B163
X307
$58.90 Per Pair
Base Wedge B114
X309
$124.45 Each
Pelvic obliquity build-up B116R or L
X520
$50.35 Each
X464
$266.95 Each
Generic Commercial Seating Component - Use generic pricing method
Lateral Thigh Support/Adductors
1 Thigh Support Per Leg Per 3
Years
Price to include pad and hardware if required.
Obliquity Pad/Build-up/Fluid Supplement
Pommel/Thigh Abductor
1 Addition Per 3 Years
1 Pommel Per 3 Years
Price to include pad and hardware if required
1 Wedge Per 3 Years
Seat/Base
Full Wedge
Hemi Wedge
Jay
Fluid Supplement
F119
1 Fluid Supplement Per 3 Years
Jay Seat Wedge
Adductor 1" B119J
1 Pair of Adductors Per 3 Years
Western Home Medical
1 Abductor Per 3 Years
Abductor
Flip-down
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X053
$178.52 Each
X350
$667.46 Each
Non-removable Pommel, rigid support foam covering and hardware for attachment
of non-removable pommel
X133
$226.77 Each
Removable Pommel, rigid support foam covering inner/outer hardware
X023
$310.18 Each
Custom-Made
Abduction Stop
1 Abduction Stop Per Side Per 3
Years
Rigid shell, foam & covering
1 Pommel Per 3 Years
Pommel
Flip Down Pommel, rigid support foam covering inner/outer hardware
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 15 of 36
APL X-14
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
07. Sub-ASIS Bars & Belts
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X100
$415.17 Max. Each
X105
$223.25 Max. Each
X472
$223.25 Each
1 Sub-ASIS Belt/Bar Per 4 Years
Swing Away Sub-ASIS Bar
With mid relief, includes 2-90 degree Brackets, 1 universal swing away bracket, 1
X580
offset sub-asis bar with mid relief, 2 hours labour
$415.17 Each
Generic Commercial Seating Component - Use generic pricing method
Sub-ASIS Bar
Rigid Sub-ASIS pelvic control.
1 Sub-ASIS Belt/Bar Per 4 Years
Client eligible for either X100 or X105
Sub-ASIS Belt
Soft Sub-ASIS pelvic control.
1 Sub-ASIS Belt/Bar Per 4 Years
Client eligible for either X100 or X105
Bodypoint
1 Sub-ASIS Belt/Bar Per 4 Years
Sub-ASIS Belt
Medial 4pt center pull
Metalcraft
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X600
$419.29 Each
Custom-Made
Sub-ASIS Bar
Semi-rigid Sub-ASIS Bar, or ACH Y-belt
1 Sub-ASIS Belt/Bar Per 4 Years
To be added to X033 when appropriate.
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 16 of 36
APL X-15
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
08. Foot & Leg Supports & Hardware
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X955
$114.00 Max. Each
X080
$79.80 Max. Each
Generic Commercial Seating Component - Use generic pricing method
Footbox/Foot Pocket
Semi-enclosed leg and footrest
1 Footbox Per Foot Per 2 Years
If footbox/footpocket is for bilateral feet then use quantity of 2.
1 Support Per Foot Per 4 Years
Modified Foot Support
Modified/adapted footplate, shoe holders, padded footrests or footboards.
Price represents cost for one foot, ie: 1 footboard = quantity of 2, or 1 shoe holder = quantity of 1
Bodypoint
1 Pair Footstraps Per 12 Months
Ankle Huggers
Medium/large
X971
$185.25 Per Pair
X415
$92.15 Each
X495
$228.00 Each
X763
$28.50 Each
X771
$56.64 Each
X446
$214.70 Each
X447
$254.60 Per Pair
X519
$159.60 Per Pair
X448
$34.30 Each
1 Calf Panel Per 12 Months
Calf panel
Maple Leaf Wheelchair
Footbox
Contractive Sling - 1 piece padded footbox
1 Footbox Per 2 Years
Nighthawk
1 Toe Loop Per Foot Per 12
Months
Toe Loops
Variety Village
1 Footpocket Per Foot Per 2
Years
Foot Pockets
Western Home Medical
Footbox
One Piece cushioned Footbox #5081
1 Footbox Per Foot Per 2 Years
Western Split Cushion Footbox #5082
1 Pair Shoe Holders Per 4 Years
Rigid Shoe Holders
1 Toe Loop Per Foot Per 12
Months
Toe Loops
#5086
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X061
$231.90 Each
Custom-Made
Calf Support
Rigid shell, foam, covering
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Support Per Leg Per 2 Years
Page 17 of 36
APL X-16
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AADL Seating Approved Product List
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08. Foot & Leg Supports & Hardware
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X127
$399.45 Each
X059
$191.19 Each
X057
$163.75 Each
X106
$110.81 Each
X129
$502.24 Each
X468
$105.69 Each
Custom-Made
Footbox
Includes both feet
Footpocket
Footrest
Footstrap/Toe Loop
Knee Block
Rigid shell, foam, covering and straps
Neoprene Padding of Front Rigging
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Footbox Per 4 Years
1 Footpocket Per Foot Per 2
Years
1 Footrest Per Foot Per 4 Years
1 Strap Per Foot Per 12 Months
1 Knee Block Per 4 Years
1 Padding Per Leg Per 3 Years
Page 18 of 36
APL X-17
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AADL Seating Approved Product List
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09. Arm, Hand & Shoulder Supports
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X166
$334.63 Per Pair
X043
$199.51 Each
X141
$96.02 Each
Custom-Made
Armrest with hardware
Elbow Stops
1 Pair Per 2 Years
1 Elbow Stop Per Arm Per 2
Years
Added to trays
Shoulder Protraction Wedges
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
2 Wedges Per 2 Years
Page 19 of 36
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AADL Seating Approved Product List
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10. Trays
Level I Seating - Commercial Seating Components
Qty. / Freq.
Commercial Tray Customization
Cat. No.
AADL Price
X587
$67.85 Each
X068
$213.15 Max. Each
X060
$312.31 Max. Each
1 Tray Customization Per 2
Years
To accommodate a power wheelchair control box
Generic Commercial Seating Component - Use generic pricing method
Bayonet Mounting on Tray
Communication Board Mount to Seating System
1 Mount Per 2 Years
1 Mount Per 2 Years
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X351
$504.73 Each
Including mounting hardware, lexan, added lip
X054
$678.81 Each
Including mounting hardware, lexan, heavy duty bayonet, added lip
X381
$849.00 Each
Including mounting hardware, lexan, heavy duty bayonet, no lip
X380
$692.19 Each
To accommodate communication device, includes mounting hardware
X056
$526.83 Each
Custom-Made
Tray
Including mounting hardware - padding
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Tray Per 2 Years
Page 20 of 36
APL X-19
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11. Backs & Replacement Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X124
$646.00 Max. Each
< 3" Contour Depth, ≥ 20" Tall, Any width
X126
$750.00 Max. Each
< 3" Contour Depth, 16" - 19" Tall, Any width
X125
$726.75 Max. Each
≥ 6" Contour Depth, ≤ 15" Tall, Any Width
X150
$736.25 Max. Each
≥ 6" Contour Depth, ≥ 20" Tall, Any width
X155
$864.50 Max. Each
≥ 6" Contour Depth, 16" - 19" Tall, Any width
X152
$840.75 Max. Each
3"-5" Contour Depth, ≤ 15" Tall, Any Width
X130
$717.25 Max. Each
3"-5" Contour Depth, ≥ 20" Tall, Any width
X134
$807.50 Max. Each
3"-5" Contour Depth, 16" - 19" Tall, Any width
X132
$783.75 Max. Each
Non-Standard/Custom Size
X935
Prior Approval
Generic Commercial Seating Component - Use generic pricing method
Back
< 3" Contour Depth, ≤ 15" Tall, Any width
1 Back Per 4 Years
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL. Cannot be combined with X200.
Planar "I"-Shape, ≤ 13" Wide, Any height
X120
$755.25 Max. Each
Planar "I"-Shape, ≥ 13" Wide Any height
X122
$813.25 Max. Each
X200
$300.00 Max. Each
3 Bariatric Option Per 4 Years
Back Bariatric Option
Weight capacity over 300lbs or widths greater than 20"
Add to appropriate Back catalogue number. Invoice only for the difference in cost for bariatric size, up to $300
maximum.
Combined total quantity of 3 in 4 years for X200 and X333.
1 Replacment Cover Per 4 Years
Back Cover
Custom size replacement cover for commercial systems for adults & peds.
X169
For replacement only. Prior Approval. Submit spec sheets and clinical rationale to AADL.
Standard size back replacement cover for commercial systems for adults & peds.
X171
Prior Approval
Prior Approval
For replacement only. Prior Approval. Submit spec sheets and clinical rationale to AADL.
Future Mobility
Air Back
14x14, 17x16, 19x16, 16x18, 18x18, 17x20, 19x20 20x18
1 Back Per 4 Years
X412
$902.50 Each
16x16, 18x16, 20x16, 18x20, 20x18, 16X20, 20X20
X411
$760.00 Each
Bariatric size
X371
$1,140.00 Each
I220
$674.50 Each
X409
$105.00 Each
Lunar Back
Mid Back - No Lateral
Max Back Option
For Prism Air Back and Truefitt
1 Back Per 4 Years
1 Option Per 4 Years
Use this catalogue number with the applicable Future Mobilty Air or Truefitt back. $105 is the maximum, not all
Max Backs require full amount.
Phantom Back
12-18" x 7"
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Back Per 4 Years
X443
$379.05 Each
Page 21 of 36
APL X-20
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AADL Seating Approved Product List
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11. Backs & Replacement Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X369
$584.25 Each
11x12, 11x14, 12x14, 12x16, 13x12, 13x14, 13x16, 14x16, 15x12, 15x14, 15x16,
16x12, 16x14
X279
$679.25 Each
14x14, 16x18, 17x16, 17x20, 18x18, 19x16, 19x20, 20x18
X370
$712.50 Each
X417
$831.25 Each
16x18, 16x20, 17x16, 17x20, 18x18, 18x20, 20x18, 20x20
X374
$878.75 Each
Bariatric size
X375
$1,187.50 Each
X431
$680.20 Each
Deep Back 13-19" 250 lbs. max.
X433
$826.50 Each
Heavy Duty Back 19-25" 500 lbs. max.
X432
$973.75 Each
X199
$850.25 Each
X455
$709.65 Each
X213
$611.80 Each
X368
$905.35 Each
X693
$768.55 Each
X367
$1,062.10 Each
X101
$703.95 Each
Fits 20"
X659
$785.65 Each
Tall - fits 14, 15, 16, 17, 18, 19" W/C
X098
$806.55 Each
Tall - fits 20"
X610
$930.05 Each
X970
$734.35 Each
X353
$781.85 Each
X373
$804.65 Each
Future Mobility
Prism Basic Back
10x12, 12x12, 16x16, 16x20, 18x16, 18x20, 20x16, 20x20
TrueFitt Back
16x16, 18x16, 20x16
1 Back Per 4 Years
1 Back Per 4 Years
Invacare
Matrx PB Back
13-20" 250 lbs. max.
Matrx PB Elite Back
Deep Back
1 Back Per 4 Years
1 Back Per 4 Years
Widths 12-20, ht 12, 16, 20 wt capacity 300 lbs.
Personal Back 10
Reg. Height or Tall (13-20"), aluminum hardware
1 Back Per 4 Years
Reg. Height or Tall (22", 24", 26"), Bariatric, steel hardware, max. 500 lbs.
Personal Back 10 Plus
13-20", steel hardware
1 Back Per 4 Years
Reg. Height or Tall (22", 24", 26"), Bariatric, steel hardware, max. 500 lbs.
Jay
J2 Back
Fits 12, 13, 14, 15, 16, 17, 18, 19" W/C
J2 Deep Contour Back
14, 15, 16, 17, 18, 19"
1 Back Per 4 Years
1 Back Per 4 Years
20"
J2 Plus Back
20-23", 23-26" without headrest mounting kit
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Back Per 4 Years
Page 22 of 36
APL X-21
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AADL Seating Approved Product List
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11. Backs & Replacement Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X421
$532.00 Each
Lower Thoracic (6" deep and post contour) -14,16,18,20, (SMT)
X413
$617.50 Each
Mid Thoracic (2.2" contour) - 12, 14, 16, 18, 20, (SMT)
X422
$646.00 Each
Mid Thoracic (3" contour) 12, 14, 16, 18, 20, (SMT)
X423
$717.25 Each
Mid Thoracic (6" deep and post contour) 14, 16, 18, 20, (SMT)
X784
$736.25 Each
Shoulder Ht. (2.2" contour) 14, 16, 18, 20, (SMT)
X476
$750.50 Each
Shoulder Ht. (3" contour) 14, 16, 18, 20, (SMT)
X477
$807.50 Each
Shoulder Ht. (6" contour) 14, 16, 18, 20, (SMT)
X478
$864.50 Each
Shoulder Ht. (6" deep and post contour) 16,18,20, (SMT)
I204
$878.75 Each
Upper Thoracic (2.2" contour) 12, 14, 16, 18, 20, (SMT)
X424
$726.75 Each
Upper Thoracic (3" contour) 12, 14, 16, 18, 20, (SMT)
X425
$783.75 Each
Upper Thoracic (6" contour) 14, 16, 18, 20, (SMT)
X475
$840.75 Each
Upper Thoracic (6" deep and post contour) 14, 16, 18, 20, (SMT)
X787
$850.25 Each
I211
Prior Approval
Jay
Jay 3 Back
Lower Thoracic (2.2" contour) -12, 14, 16, 18, 20, (SMT)
Jay 3 Components
1 Back Per 4 Years
3 Components Per 4 Years
For base or back after device provided. Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
1 Back Per 4 Years
Jay Active Back
With Quick Release Brackets 520/522/525/527/528 (14", 15", 16", 17", 18")
X566
$512.05 Each
X093
$629.85 Each
X658
$740.05 Each
X492
$756.20 Each
X465
Prior Approval
X461
$799.90 Each
ML Deep, Mid or Shallow shell – tall 22”/24
X462
$799.90 Each
ML Deep, Mid or Shallow shell 10”-‐20” (1”increments) 18” ht., standard ht. Laterals
(10 ½”)
X460
$632.70 Each
Jay Care Back
3500B/3505B 16" and 18" W/C
1 Back Per 4 Years
3502 - 20"
Jay Focus Back
1 Back Per 4 Years
Maple Leaf Wheelchair
Kyphotic Back Options
Laterals ht. and back ht.
1 Option Per 4 Years
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
ML Kyphotic Back
ML Deep, Mid or Shallow shell – bariatric width
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Back Per 4 Years
Page 23 of 36
APL X-22
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AADL Seating Approved Product List
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11. Backs & Replacement Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
I231
$750.50 Each
Support Contour or Active Contour
I217
$655.50 Each
Vicair Contour 16,17,18x16/20 18,19,20x16/20 20,21,22X16/20
I228
$945.25 Each
I214
$655.50 Each
I215
$684.00 Each
X660
$490.05 Each
Back 2 - 15-17", 18-20"
X978
$627.38 Each
Back 3 15-17", 18-20" with or without teardrop laterals
X979
$748.90 Each
Back 4 - 15-17", 18-20" with or without teardrop laterals
X980
$980.10 Each
X981
$17.78 Each
X434
$759.05 Each
X466
$783.75 Each
X489
$465.50 Each
X488
Prior Approval
nxt
1 Back Per 4 Years
Fixed Height
Plus Contour
1 Back Per 4 Years
Height Adjustable
Support contour/active countour/plus count HA SC/AC/PC 16-22
Support contour/plus contour HA SC/ PC 22-24
Ottobock
1 Back Per 4 Years
Back
Back 1 - 15-17", 18-20"
8 Floam Cells Per 4 Years
Floam Cells
Pride Mobility
1 Back Per 4 Years
Synergy Shape 2 Back
14, 16, 18, 19, 20", 300 lbs max. 4" depth adjustment angle adjustment from -33 to
+57 degrees
Tall 16,18,20,22" X 23" 300 lbs max. 4" depth adjustment, angle adjustment
from -33 - +57 degrees
Ride
Ride Back
Corbac Adjustable Contour
1 Back Per 4 Years
Custom
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X671
$886.90 Each
Lumbar Support
X049
$173.15 Each
Planar Back Interface System
X067
$633.61 Each
Pressure reduction back with polymer or air floatation insert
X179
Prior Approval
Custom-Made
Back
Contoured
1 Back Per 4 Years
Prior Approval. Submit request to AADL. (custom back $493.00 + cost of pressure relief surface)
Web Back Box
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
X151
$849.90 Each
Page 24 of 36
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11. Backs & Replacement Covers
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X670
$586.39 Each
X469
$105.69 Each
X383
$330.41 Each
X401
$232.34 Each
Custom-Made
Back
Web Back Sling
Neoprene Padding of Back Canes
Removable Cover
Neoprene option
1 Back Per 4 Years
1 Padding Per 4 Years
1 Cover Per 4 Years
Replacement only
Standard
Replacement only
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 25 of 36
APL X-24
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12. Bases, Cushions & Replacement Covers
Level I Seating - Commercial Seating Components
Qty. / Freq.
Wheelchair Cushions provided on "V" APL
Cat. No.
AADL Price
X633
$20.00 Each
X934
Prior Approval
I101
Prior Approval
1 Service Fee Per 3 Years
Generic Commercial Seating Component - Use generic pricing method
1 Cushion Per 3 Years
Cushion
Non-Standard Size
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
1 Cover Per 12 Months
Replacement Cushion Cover for Commercial
Custom Cushion
For replacment only. Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Jay
1 Seat Insert Per 3 Years
Adult Adjustable Solid Seat
#270/271/272 (adjusts 15-18", 10-11", 11.5-14.5") 1.5" drop
Large 273 (adjusts 18.5-22" wide) 2.5" drop
X249
$323.95 Each
X384
$399.00 Each
I211
Prior Approval
3 Components Per 4 Years
Jay 3 Components
For base or back after device provided. Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Jay 3 Cushion
Air or fluid insert with seating component options.
1 Cushion Per 3 Years
X496
Prior Approval
X497
Prior Approval
X430
Prior Approval
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Bariatric, air or fluid insert with seating component options
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Ride
1 Base Per 3 Years
Ride Cushion
Custom
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X149
$799.62 Each
Bariatric - over 250 lbs.
X382
$816.65 Each
Kid Kart
X618
$403.00 Each
Pressure Reduction Base (polymer or air floatation insert)
X999
Prior Approval
Standard Cushion/Base
X066
$770.99 Each
T-Foam/Sunmate Cushion
X051
$209.49 Each
Custom-Made
Base
Anti-thrust Seat or Non-Removable Pommel
1 Base Per 3 Years
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 26 of 36
APL X-25
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AADL Seating Approved Product List
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12. Bases, Cushions & Replacement Covers
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X356
$448.36 Each
X197
$137.33 Each
X383
$330.41 Each
X401
$232.34 Each
X471
$127.83 Each
X470
$542.10 Each
Custom-Made
Drop Base
Padded
1 Drop Base Per 3 Years
Standard
Hooks not included. Previously X534.
Removable Cover
Neoprene option
1 Cover Per 4 Years
Replacement only
Standard
Replacement only
Solid Seat Insert
Pre ischial shelf - for beneath an air floatation cushion
With leg channels upholstered to base
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Seat Insert Per 3 Years
Page 27 of 36
APL X-26
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13. Spinal Alignment Assessories
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X333
$47.50 Max. Each
Large/Small Lumbar
X479
$47.50 Each
Lateral Shim
X483
$52.25 Each
Post/Lateral Pelvic
X482
$52.25 Each
Wedge
X480
$38.00 Each
Generic Commercial Seating Component - Use generic pricing method
Accessories for Commercial Back
3 Accessories Per 4 Years
List each accessory and justification in benefit note on E-business.
Jay
Jay 3 Spinal Alignment Accessories
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
3 Spinal Alignment Accessories
Per 4 Years
Page 28 of 36
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14. Complete Seating Systems
Level I Seating - Commercial Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X190
Prior Approval
Generic Commercial Seating Component - Use generic pricing method
Adult Commercial Custom Fit Seating System
Must include back, base and all supports
1 Seating System Per 4 Years
Must only provided when seating needs cannot be accomodated by off-the-shelf components. Prior Approval.
Submit spec sheets/pricing and clinical rationale to AADL.
Pediatric Commercial Custom Fit Seating System
Must include back, base and all supports.
1 Seating System Per 2 Years
I229
Prior Approval
For ages 17 years and younger.
Must only provided when seating needs cannot be accomodated by off-the-shelf components. Prior Approval.
Submit spec sheets/pricing and clinical rationale to AADL.
Jay
Additional Seating Components for SureFit System
4 Components Per 4 Years
I207
Prior Approval
To be used only after original seating provided. Prior Approval. Submit spec sheets/pricing and clinical rationale to
AADL.
Lecky
4 Per 4 Years
Squiggles Additional Seating Components
I201
Prior Approval
Components added to Lecky Squiggles seating insert after provision. To be used only after original seating
provided. Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
Ottobock
1 Cover Per 4 Years
Ottobock Shape System
Replacement cover
X454
$230.85 Each
Pattern on client file must be sent to Ottobock
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X024
$2,004.50 Each
Custom-Made
"Foam-in-Place" Back or Base
Custom-made foam back or base.
1 Back or Base Per 4 Years
May be custom-made by Adaptive Seating Technician or using computerized scanning/carving.
If both back and base required, do not submit QFR. Indicate rationale for override in the Override Notes on Ebusiness.
1 Seating System Per 4 Years
ACH - Custom Made Insert for Commercial Stroller
Includes custom made headrest/neckrest, foam and covering and pelvic strap.
X036
$1,092.95 Each
X044 Custom-Made Safety Strap used to secure insert to mobility base added as separate catalogue number.
Base
Kid Kart
Commode Insert
Includes: back, laterals, footstraps, chest straps - no seat.
1 Cushion Per 3 Years
X618
$403.00 Each
X047
Prior Approval
1 Insert Per 4 Years
Prior Approval. Submit spec sheets/pricing and clinical rationale to AADL.
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
14. Complete Seating Systems
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
AADL Price
X636
$1,092.95 Each
Custom-Made
1 Seating System Per 4 Years
Glenrose Infant Seat
Custom made insert for commercial stroller, includes custom made
headrest/neckrest, foam and covering and pelvic strap.
X044 CUSTOM MADE Safety Strap used to secure insert to mobility base added as separate cat#
GRIP Seat
Floor Sitter
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
1 Floor Sitting Per 4 Years
X474
$172.00 Each
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
15. Service Fees
Level I Seating - Commercial Seating Components
Qty. / Freq.
Commercial Tray Customization
AADL Price
X587
$67.85 Each
X632
$15.00 Each
1 Tray Customization Per 2
Years
To accommodate a power wheelchair control box
Hand/Arm/Shoulder Supports as provided from
"V" APL
Cat. No.
1 Service Fee Per 2 Years
50% of Replacement Cost Per 4
Years
Repairs/modifications to an existing seating system; transferring seating system to
X964
another mobility base. Price includes labour and materials. If authorized on Ebusiness, document type of repairs and cost breakdown.
Level I - Repairs/Modifications
$67.85 Per Hour
Invoiced in 1/4 hour
Increments
- Cost under $25 are client's responsibility
- Not to be used for repairs due to misuse of equipment
- Each increment of $67.85 = Quantity of 1. Total materials/labour of $185 = Qty 3 (2 @ $67.85, 1 @ $49.30)
Recycle Fee for Seating Benefits
1 Recycle Fee Per Seating
System
List recycled components in Benefit Note
X651
$67.85 Per HourPer
Hour Invoiced in 1/4
hour Increments
X357
Prior Approval
X783
$57.00
X633
$20.00 Each
- Maximum 4 hours
Shipping Fee
Commercial Seating Components/System Repairs
1 Fee Per Component
Submit invoice to AADL
Retrieval of Trial Seating Equipment Rural - One way
Wheelchair Cushions provided on "V" APL
1 Service Fee Per 3 Years
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Cat. No.
50% of Replacement Cost Per 4
Years
Repairs/modifications to an existing seating system; transferring seating system to
X172
another mobility base. Price includes labour and materials. If authorized on Ebusiness, document type of repairs and cost breakdown.
AADL Price
Level II - Repairs/Modifications
$67.85 Per Hour
Invoiced in 1/4 hour
Increments
- Cost under $25 are client's responsibility
- Not to be used for repairs due to misuse of equipment
- Each increment of $67.85 = Quantity of 1. Total materials/labour of $185 = Qty 3 (2 @ $67.85, 1 @ $49.30)
Recycle Fee for Custom Seating Benefits
List recycled components in Benefit Note
4 Hours Per Seating System
X377
$67.85 Per Hour
Invoiced in 1/4 hour
Increments
- Maximum 4 hours
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 31 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
15. Service Fees
Level II Seating - Custom-Made Seating Components
Qty. / Freq.
Shipping Fee
Custom-Made Seating Components/System Repairs
Cat. No.
AADL Price
X358
Prior Approval
1 Fee Per Component
Submit invoice to AADL
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 32 of 36
APL X-31
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
2014 Catalogue Number Updates
I204
Jay 3 Back Shoulder Ht. (6" deep and post contour) 16,18,20, (SMT) Price Change
I205
Synergy Shape 2 Back Low back 14,16,18, 20" 16" ht 300lbs max.
4" depth adjustment, angle adjustment from -33 - +57 degrees
Deleted: Falls under generic back
code; 0 consumption in 3 years
I208
Lunar Back Heavy Duty - Mid Back
Deleted: Falls under generic back
code; 0 consumption in 3 years
I209
Lunar Back Heavy Duty - Full Back
Deleted: Falls under generic back
code; 0 consumption in 3 years
I212
Heel Loop and Ankle Strap
Deleted: Falls under X070; 0
consumption in 3 years
I213
Back Accessories Lumbar support pads; lateral support pads.
Deleted: Falls under X333; 0
consumption in 3 years
I218
Lunar Back Low Back - No Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I219
Lunar Back Low Back - Basic Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I221
Lunar Back Mid Back - Basic Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I222
Lunar Back Mid Back - Ultra Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I223
Lunar Back Full Back - No Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I224
Lunar Back Full Back - Basic Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I225
Lunar Back Full Back - Ultra Lateral
Deleted: Falls under generic back
code; 0 consumption in 3 years
I226
Lunar Back - Swing-away Laterals
Deleted: Falls under generic back
code; 0 consumption in 3 years
I229
Pediatric Commercial Custom Fit Seating System Must include back, New
base and all supports.
X015 Headrest/Neckrest Standard Headrest or Neckrest
Price Change
X035 Headrest/Neckrest Headrest with Lateral Support
Price Change
X045 Hardware for Headrest/Neckrest
Price Change
X062 Adaptor Kit or Mounting Plate for Headrest/Neckrests
Price Change
X069 Headrest Styles Lg/Sm 430C1 = 1-7/3-7, or 430H1 = 1-7/3-7
Price Change
X070 Heel Loop/Ankle Strap Strapping mechanism to secure ankle/foot.
Price Change
X078 Headrest Hardware Multi-Axis Offset or Multi-Axis Straight
Price Change
X079 Headrest Hardware Adaptor Kit
Price Change
X093 Jay Care Back 3500B/3505B 16" and 18" W/C
Price Change
X098 J2 Back Tall - fits 14, 15, 16, 17, 18, 19" W/C
Price Change
X101 J2 Back Fits 12, 13, 14, 15, 16, 17, 18, 19" W/C
Price Change
X115 Seat/Base Full Wedge
Price Change
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 33 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
X118 Obliquity Pad/Build-up/Fluid Supplement
Price Change
X150 Back ≥ 6" Contour Depth, ≤ 15" Tall, Any Width
Price Change
X152 Back ≥ 6" Contour Depth, 16" - 19" Tall, Any width
Price Change
X155 Back ≥ 6" Contour Depth, ≥ 20" Tall, Any width
Price Change
X189 AES SureFit (Li'l Kiddos) Seating System - Size 14" or less.
Complete seating system including back, base, headreat and all
supports.
Deleted: Falls under X190
X194 Squiggles Seating Insert
Deleted: Falls under X190
X249 Adult Adjustable Solid Seat #270/271/272 (adjusts 15-18", 10-11",
11.5-14.5") 1.5" drop
Price Change
X305 J2 Abductor Build-up 2" B118 or B168
Deleted: Falls under X118; 0
consumption in 3 years
X306 Jay Seat Wedge Adductor 1" B119J
Price Change
X307 Jay Seat Wedge Adductor 2" B113J or B163
Price Change
X308 Fluid Supplement F119
Price Change
X309 Jay Seat Wedge Base Wedge B114
Price Change
X331 Clamp To mount headrest or other seating component
Price Change
X353 J2 Deep Contour Back 20"
Price Change
X360 Back Mounting Brackets Infinity Back 1109570
Deleted: Discontinued
X361 Pelvic Belt K Belt 5065 or Y Belt 5067 padded
Deleted: Falls under X227; 0
consumption in 3 years
X363 Neckrest 430N1, Large, Medium, Small
Deleted: Discontinued
X372 Prism Basic Back Bariatric, max. 24" width, min. 14" height
Deleted: Falls under generic back
code; 0 consumption in 3 years
X373 J2 Plus Back 20-23", 23-26" without headrest mounting kit
Price Change
X376 Back Mounting Brackets Personal Back 10 1116448 - 13-20", 22-26" Deleted: Discontinued
W/C
X385 Ottobock Shape System Soft Spot Foam
Deleted: Falls under X190
X385 Ottobock Shape System Soft Spot Foam
Price Change
X386 Headrest Hardware Gooseneck Mounting Kit 476L52-SK030 or
Straight Mounting Kit 476L52-SK035
Price Change
X387 STS Clamps 477D52/434H1
Price Change
X389 Ottobock Shape System Finished back with spray coating.
Removable cover and cover pattern.
Deleted: Falls under X190
X390 Ottobock Shape System Unfinished back. Removable cover and
cover pattern.
Deleted: Falls under X190
X391 Headrest Soft Headrest 430H2
Price Change
X394 Ottobock Shape System Plywood Mounting Surface - Back or seat
Deleted: Falls under X190
X395 Ottobock Shape System Finished seat with spray coating.
Removable cover and cover pattern.
Deleted: Falls under X190
X396 Ottobock Shape System Unfinished seat. Removable cover and
cover pattern.
Deleted: Falls under X190
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 34 of 36
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AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
X397 Ottobock Shape System Plastic (ABS) Mounting Surface - back or
seat
Deleted: Falls under X190
X398 Hardware Kit 5069 - includes 4 chafes and 4 slides per pkg.
Deleted: Falls under X107; 0
consumption in 3 years
X405 Waistcoat
Price Change
X416 Matrx Flo-Tech Seat Wedge Adductor - Front or rear
Deleted: Falls under X114; 0
consumption in 3 years
X420 AES Structured Y Shoulder Strap
Price Change
X453 Ottobock Shape System Additional components
Deleted: Falls under X190; 1
consumption in 3 years
X454 Ottobock Shape System Replacement cover
Price Change
X458 Ottobock Shape System T-Nuts
Deleted: Falls under X190
X458 Ottobock Shape System T-Nuts
Price Change
X460 ML Kyphotic Back ML Deep, Mid or Shallow shell 10”--‐20”
(1”increments) 18” ht., standard ht. Laterals (10 ½”)
Price Change
X461 ML Kyphotic Back ML Deep, Mid or Shallow shell – bariatric width
Price Change
X462 ML Kyphotic Back ML Deep, Mid or Shallow shell – tall 22”/24
Price Change
X472 Sub-ASIS Belt Medial 4pt center pull
Price Change
X475 Jay 3 Back Upper Thoracic (6" contour) 14, 16, 18, 20, (SMT)
Price Change
X478 Jay 3 Back Shoulder Ht. (6" contour) 14, 16, 18, 20, (SMT)
Price Change
X481 Jay 3 Spinal Alignment Accessories Curved Shim or Flat Shim
Deleted: Falls under X333; 0
consumption in 3 years
X482 Jay 3 Spinal Alignment Accessories Post/Lateral Pelvic
Price Change
X483 Jay 3 Spinal Alignment Accessories Lateral Shim
Price Change
X484 Chest Strap Jay 3 Chest Straps/Harnesses
Price Change
X486 Headrest Jay 3 AXYS Mount
Price Change
X487 Headrest Jay 3 COBRA Mount
Price Change
X490 Back Mounting Brackets Jay 3 back hardware
Price Change
X492 Jay Focus Back
Price Change
X493 U-Shape Back Shallow
Deleted: Falls under generic back
code; 1 consumption in 3 years
X494 U-shape Back Deep
Deleted: Falls under generic back
code; 1 consumption in 3 years
X498 Chest Strap MonoFlex anterior trunk support
Price Change
X499 Signature-Fit
Deleted: Falls under X190
X514 Matrx Flo-Tech Fluid Supplement
Deleted: Falls under X118; 0
consumption in 3 years
X515 Matrx Flo-Tech Seat Wedge Full
Deleted: Falls under X115; 0
consumption in 3 years
X516 Matrx Flo-Tech Seat Wedge Hemi
Deleted: Falls under X116; 0
consumption in 3 years
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 35 of 36
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Alberta
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Alberta Health
- Professional
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andand
Health
AADL Seating Approved Product List
Alberta Aids to Daily Living - Manual X - Seating Approved Product List
X517 Matrx Flo-Tech Seat Wedge Tapered
Deleted: Falls under X115; 0
consumption in 3 years
X518 Matrx Flo-Tech Seat Wedge Pelvic obliquity 1"
Deleted: Falls under X118; 0
consumption in 3 years
X520 Jay Seat Wedge Pelvic obliquity build-up B116R or L
Price Change
X521 Hip Guide Jay, J2, GS - B1167
Deleted: Falls under X112; 1
consumption in 3 years
X522 Headrest Lateral Control Headrest 430C2 1-7/3-7
Price Change
X610 J2 Back Tall - fits 20"
Price Change
X649 Matrx Elite Thoracic Lateral Rigid
Price Change
X652 Matrx Elite Thoracic Lateral Off-Set
Price Change
X658 Jay Care Back 3502 - 20"
Price Change
X659 J2 Back Fits 20"
Price Change
X660 Back Back 1 - 15-17", 18-20"
Price Change
X713 STS Hardware Rod Assembly 434F1
Price Change
X787 Jay 3 Back Upper Thoracic (6" deep and post contour) 14, 16, 18,
20, (SMT)
Price Change
X788 Headrest Clamp Invacare Universal / Whitmeyer Headrest Clamp
Deleted: Discontinued
X812 OB STS Pad Large/med/small 434P1
Price Change
X868 Headrest Adpator Kit 476D52 SK010/015/020/025/060/065
Price Change
X907 Hooks Drop Hooks 1063290-95
Price Change
X911 OB STS Clamp 434H1=1
Price Change
X942 Pelvic Belt Y Belt, black webbing N4.025
Deleted: Falls under X227; 0
consumption in 3 years
X969 Headrest Hardware Clamp For any back (477152=SK039)
Price Change
X970 J2 Deep Contour Back 14, 15, 16, 17, 18, 19"
Price Change
X971 Ankle Huggers Medium/large
Price Change
X978 Back Back 2 - 15-17", 18-20"
Price Change
X979 Back Back 3 15-17", 18-20" with or without teardrop laterals
Price Change
X980 Back Back 4 - 15-17", 18-20" with or without teardrop laterals
Price Change
X981 Floam Cells
Price Change
© 2013 ©
Government
of
2014 Government of Alberta
Alberta April
April1,1,2014
2014
Page 36 of 36
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