K0002 — Standard hemi (low seat) wheelchair
HCPCS Level II K-code · short descriptor: “Stnd hemi (low seat) whlchr”
- 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
- Required from 2026-10-28 (Manual wheelchairs)
- 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))
F2F + WOPD FROM 2026-10-28 K0002 joins Medicare's Required Face-to-Face & WOPD List for dates of service on or after 2026-10-28 (Manual wheelchairs — CMS-6109-N, 91 FR 47972 (published 2026-07-30)). From that date two extra conditions of payment apply:
- Face-to-face encounter (in-person or telehealth) with the treating practitioner within the 6 months before the order date
- Written order communicated to the supplier before delivery (WOPD)
Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.
K0002 Medicare fee schedule (October 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $38.93 to $101.05 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $101.05 | — |
| AL | $54.13 | $85.38 |
| AR | $54.13 | $85.38 |
| AZ | $46.32 | $85.38 |
| CA | $54.14 | $78.84 |
| CO | $53.56 | $85.38 |
| CT | $38.93 | $82.37 |
| DC | $45.70 | $85.38 |
| DE | $45.70 | $85.38 |
| FL | $54.13 | $76.63 |
| GA | $54.13 | $76.63 |
| HI | $90.13 | — |
| IA | $46.80 | $85.38 |
| ID | $53.56 | $76.63 |
| IL | $49.99 | $85.38 |
| IN | $49.99 | $85.38 |
| KS | $46.80 | $85.38 |
| KY | $54.13 | $85.38 |
| LA | $54.13 | $85.38 |
| MA | $38.93 | $80.93 |
| MD | $45.70 | $85.38 |
| ME | $38.93 | $82.52 |
| MI | $49.99 | $82.52 |
| MN | $46.80 | $77.70 |
| MO | $46.80 | $85.38 |
| MS | $54.13 | $76.63 |
| MT | $53.56 | $76.88 |
| NC | $54.13 | $79.07 |
| ND | $46.80 | $82.35 |
| NE | $46.80 | $82.60 |
| NH | $38.93 | $77.94 |
| NJ | $45.70 | $85.38 |
| NM | $46.32 | $85.38 |
| NV | $54.14 | $85.38 |
| NY | $45.70 | $85.07 |
| OH | $49.99 | $85.38 |
| OK | $46.32 | $82.36 |
| OR | $54.14 | $84.76 |
| PA | $45.70 | $85.38 |
| PR | $89.64 | — |
| RI | $38.93 | $76.63 |
| SC | $54.13 | $85.38 |
| SD | $46.80 | $85.38 |
| TN | $54.13 | $76.63 |
| TX | $46.32 | $85.38 |
| UT | $53.56 | $85.38 |
| VA | $54.13 | $85.38 |
| VI | $85.07 | — |
| VT | $38.93 | $80.23 |
| WA | $54.14 | $76.63 |
| WI | $49.99 | $76.63 |
| WV | $54.13 | $76.83 |
| WY | $53.56 | $85.38 |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0002 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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