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.
| State | Non-rural | Rural |
|---|---|---|
| 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 |
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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