K0004 — High strength, lightweight wheelchair
HCPCS Level II K-code · short descriptor: “High strength ltwt 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
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
K0004 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $48.55 to $163.93 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $124.09 | — |
| AL | $57.95 | $109.91 |
| AR | $57.95 | $109.91 |
| AZ | $52.68 | $124.20 |
| CA | $51.77 | $109.91 |
| CO | $50.22 | $109.91 |
| CT | $48.76 | $110.22 |
| DC | $48.55 | $116.85 |
| DE | $48.55 | $109.91 |
| FL | $57.95 | $109.91 |
| GA | $57.95 | $109.91 |
| HI | $163.93 | — |
| IA | $53.13 | $124.20 |
| ID | $50.22 | $124.20 |
| IL | $52.23 | $124.20 |
| IN | $52.23 | $124.20 |
| KS | $53.13 | $124.20 |
| KY | $57.95 | $121.93 |
| LA | $57.95 | $109.91 |
| MA | $48.76 | $124.20 |
| MD | $48.55 | $109.91 |
| ME | $48.76 | $124.20 |
| MI | $52.23 | $119.89 |
| MN | $53.13 | $109.91 |
| MO | $53.13 | $124.20 |
| MS | $57.95 | $109.91 |
| MT | $50.22 | $124.20 |
| NC | $57.95 | $117.65 |
| ND | $53.13 | $124.20 |
| NE | $53.13 | $124.20 |
| NH | $48.76 | $120.06 |
| NJ | $48.55 | $110.29 |
| NM | $52.68 | $124.20 |
| NV | $51.77 | $124.20 |
| NY | $48.55 | $124.20 |
| OH | $52.23 | $109.91 |
| OK | $52.68 | $124.20 |
| OR | $51.77 | $109.91 |
| PA | $48.55 | $120.48 |
| PR | $159.23 | — |
| RI | $48.76 | $124.20 |
| SC | $57.95 | $124.20 |
| SD | $53.13 | $124.20 |
| TN | $57.95 | $124.20 |
| TX | $52.68 | $124.20 |
| UT | $50.22 | $124.20 |
| VA | $57.95 | $109.91 |
| VI | $124.20 | — |
| VT | $48.76 | $124.20 |
| WA | $51.77 | $124.20 |
| WI | $52.23 | $123.42 |
| WV | $57.95 | $116.68 |
| WY | $50.22 | $124.20 |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
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.
Common denial codes to watch
Related K-codes
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