MyMedi-AI

K0012 — Lightweight portable motorized/power wheelchair

HCPCS Level II K-code · short descriptor: “Ltwt portbl power 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
Not on the required list
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))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

K0012 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $393.59 to $543.05 depending on state and rural status.

Former-CBA payment limits: ceiling $463.05 · floor $393.59

StateNon-ruralRural
AK$531.52—
AL$453.41—
AR$463.05—
AZ$429.74—
CA$441.13—
CO$463.05—
CT$463.05—
DC$463.05—
DE$452.00—
FL$423.87—
GA$449.16—
HI$470.60—
IA$463.05—
ID$463.05—
IL$463.05—
IN$463.05—
KS$463.05—
KY$463.05—
LA$454.88—
MA$463.05—
MD$436.77—
ME$463.05—
MI$442.83—
MN$463.05—
MO$463.05—
MS$414.96—
MT$417.55—
NC$463.05—
ND$416.95—
NE$463.05—
NH$463.05—
NJ$434.49—
NM$409.32—
NV$440.14—
NY$448.97—
OH$463.05—
OK$463.05—
OR$463.05—
PA$443.78—
PR$543.05—
RI$393.59—
SC$445.89—
SD$454.12—
TN$434.07—
TX$463.05—
UT$463.05—
VA$437.17—
VI$463.05—
VT$463.05—
WA$463.05—
WI$463.05—
WV$447.42—
WY$452.70—
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.

Common denial codes to watch

Related K-codes

Bill K0012 with confidence

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