MyMedi-AI

K0006 — Heavy duty 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
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 K0006 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.

K0006 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $68.77 to $169.03 depending on state and rural status.

StateNon-ruralRural
AK$133.53—
AL$85.68$120.77
AR$85.68$118.97
AZ$76.77$132.37
CA$82.67$118.97
CO$84.80$132.37
CT$68.77$132.37
DC$72.84$132.37
DE$72.84$118.97
FL$85.68$118.97
GA$85.68$132.37
HI$161.58—
IA$72.39$132.37
ID$84.80$125.73
IL$76.92$118.97
IN$76.92$118.97
KS$72.39$132.37
KY$85.68$122.86
LA$85.68$118.97
MA$68.77$132.37
MD$72.84$118.97
ME$68.77$132.37
MI$76.92$130.71
MN$72.39$118.97
MO$72.39$132.37
MS$85.68$118.97
MT$84.80$132.37
NC$85.68$126.59
ND$72.39$132.37
NE$72.39$128.54
NH$68.77$132.37
NJ$72.84$130.21
NM$76.77$132.37
NV$82.67$132.37
NY$72.84$132.37
OH$76.92$122.46
OK$76.77$132.37
OR$82.67$132.37
PA$72.84$132.37
PR$169.03—
RI$68.77$118.97
SC$85.68$118.97
SD$72.39$132.37
TN$85.68$132.37
TX$76.77$132.37
UT$84.80$118.97
VA$85.68$118.97
VI$132.37—
VT$68.77$132.37
WA$82.67$132.37
WI$76.92$132.06
WV$85.68$118.97
WY$84.80$132.37
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 K0006 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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