MyMedi-AI

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.

StateNon-ruralRural
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
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 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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