MyMedi-AI

K0001 — Standard wheelchair

HCPCS Level II K-code

Code system
HCPCS Level II
Family
K — DME MAC temporary codes
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Capped rental
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

K0001 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $25.23 to $53.64 depending on state and rural status.

StateNon-ruralRural
AK$53.63—
AL$31.07$48.77
AR$31.07$53.64
AZ$28.52$53.22
CA$27.96$53.64
CO$27.78$53.64
CT$25.23$50.13
DC$26.42$53.64
DE$26.42$53.64
FL$31.07$48.77
GA$31.07$49.19
HI$53.63—
IA$28.87$53.64
ID$27.78$50.18
IL$29.59$53.64
IN$29.59$53.64
KS$28.87$53.64
KY$31.07$51.21
LA$31.07$53.63
MA$25.23$53.64
MD$26.42$53.64
ME$25.23$53.64
MI$29.59$53.64
MN$28.87$51.66
MO$28.87$53.64
MS$31.07$48.77
MT$27.78$52.56
NC$31.07$48.77
ND$28.87$48.77
NE$28.87$53.64
NH$25.23$52.23
NJ$26.42$53.08
NM$28.52$49.92
NV$27.96$53.54
NY$26.42$52.43
OH$29.59$53.64
OK$28.52$53.64
OR$27.96$53.64
PA$26.42$53.64
PR$53.63—
RI$25.23$53.64
SC$31.07$52.23
SD$28.87$53.64
TN$31.07$48.77
TX$28.52$53.64
UT$27.78$53.64
VA$31.07$53.64
VI$52.43—
VT$25.23$48.77
WA$27.96$53.64
WI$29.59$53.51
WV$31.07$53.64
WY$27.78$48.77
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps K0001 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related K-codes

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