MyMedi-AI

K0015 — Detachable, non-adjustable height armrest, replacement only, each

HCPCS Level II K-code · short descriptor: “Detach non-adj ht armrst rep”

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
MUE unit limit
2
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.

K0015 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $15.43 to $24.28 depending on state and rural status.

StateNon-ruralRural
AK$21.85—
AL$17.55$20.67
AR$17.55$20.67
AZ$17.29$20.48
CA$17.24$20.48
CO$18.91$20.67
CT$15.43$20.67
DC$15.60$20.63
DE$15.60$20.67
FL$17.55$20.67
GA$17.55$20.67
HI$21.85—
IA$17.88$20.48
ID$18.91$20.48
IL$18.62$20.63
IN$18.62$20.67
KS$17.88$20.48
KY$17.55$20.67
LA$17.55$20.67
MA$15.43$20.67
MD$15.60$20.63
ME$15.43$20.67
MI$18.62$20.67
MN$17.88$20.67
MO$17.88$20.67
MS$17.55$20.67
MT$18.91$20.48
NC$17.55$20.67
ND$17.88$20.48
NE$17.88$20.48
NH$15.43$20.67
NJ$15.60$20.67
NM$17.29$20.67
NV$17.24$20.48
NY$15.60$20.67
OH$18.62$20.63
OK$17.29$20.67
OR$17.24$20.48
PA$15.60$20.67
PR$24.28—
RI$15.43$20.67
SC$17.55$20.67
SD$17.88$20.48
TN$17.55$20.67
TX$17.29$20.67
UT$18.91$20.67
VA$17.55$20.63
VI$22.04—
VT$15.43$20.67
WA$17.24$20.48
WI$18.62$20.67
WV$17.55$20.63
WY$18.91$20.48

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $22.07 to $26.22 depending on state and rural status.

StateNon-ruralRural
AK$23.44—
AL—$22.29
AR—$22.29
AZ—$22.07
CA—$22.07
CO—$22.29
CT—$22.29
DC—$22.24
DE—$22.29
FL—$22.29
GA—$22.29
HI$23.44—
IA—$22.07
ID—$22.07
IL—$22.24
IN—$22.29
KS—$22.07
KY—$22.29
LA—$22.29
MA—$22.29
MD—$22.24
ME—$22.29
MI—$22.29
MN—$22.29
MO—$22.29
MS—$22.29
MT—$22.07
NC—$22.29
ND—$22.07
NE—$22.07
NH—$22.29
NJ—$22.29
NM—$22.29
NV—$22.07
NY—$22.29
OH—$22.24
OK—$22.29
OR—$22.07
PA—$22.29
PR$26.22—
RI—$22.29
SC—$22.29
SD—$22.07
TN—$22.29
TX—$22.29
UT—$22.29
VA—$22.24
VI$23.66—
VT—$22.29
WA—$22.07
WI—$22.29
WV—$22.24
WY—$22.07

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $21.93 to $26.80 depending on state and rural status.

Former-CBA payment limits: ceiling $22.32 · floor $18.97

StateNon-ruralRural
AK$21.93—
AL$22.32—
AR$22.32—
AZ$21.93—
CA$21.93—
CO$22.32—
CT$22.32—
DC$22.23—
DE$22.32—
FL$22.32—
GA$22.32—
HI$21.93—
IA$21.93—
ID$21.93—
IL$22.23—
IN$22.32—
KS$21.93—
KY$22.32—
LA$22.32—
MA$22.32—
MD$22.23—
ME$22.32—
MI$22.32—
MN$22.32—
MO$22.32—
MS$22.32—
MT$21.93—
NC$22.32—
ND$21.93—
NE$21.93—
NH$22.32—
NJ$22.32—
NM$22.32—
NV$21.93—
NY$22.32—
OH$22.23—
OK$22.32—
OR$21.93—
PA$22.32—
PR$26.80—
RI$22.32—
SC$22.32—
SD$21.93—
TN$22.32—
TX$22.32—
UT$22.32—
VA$22.23—
VI$22.32—
VT$22.32—
WA$21.93—
WI$22.32—
WV$22.23—
WY$21.93—
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 K0015 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related K-codes

K0001K0002K0003K0004K0005K0006K0007K0008K0009K0010K0011K0012

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