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K0020 — Fixed, adjustable height armrest, pair

HCPCS Level II K-code · short descriptor: “Fixed adjust armrest pair”

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
Inexpensive or routinely purchased
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.

K0020 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $56.11 to $63.14 depending on state and rural status.

StateNon-ruralRural
AK$56.11
AL$57.07$57.07
AR$57.07$57.07
AZ$56.11$56.11
CA$56.11$56.11
CO$57.07$57.07
CT$57.07$57.07
DC$57.07$57.07
DE$57.07$57.07
FL$57.07$57.07
GA$57.07$57.07
HI$56.11
IA$56.11$56.11
ID$56.11$56.11
IL$57.07$57.07
IN$57.07$57.07
KS$56.11$56.11
KY$57.07$57.07
LA$57.07$57.07
MA$57.07$57.07
MD$57.07$57.07
ME$57.07$57.07
MI$57.07$57.07
MN$57.07$57.07
MO$57.07$57.07
MS$57.07$57.07
MT$56.11$56.11
NC$57.07$57.07
ND$56.11$56.11
NE$56.11$56.11
NH$57.07$57.07
NJ$57.07$57.07
NM$57.07$57.07
NV$56.11$56.11
NY$57.07$57.07
OH$57.07$57.07
OK$57.07$57.07
OR$56.11$56.11
PA$57.07$57.07
PR$63.14
RI$57.07$57.07
SC$57.07$57.07
SD$56.11$56.11
TN$57.07$57.07
TX$57.07$57.07
UT$57.07$57.07
VA$57.07$57.07
VI$57.07
VT$57.07$57.07
WA$57.07$57.07
WI$57.07$57.07
WV$57.07$57.07
WY$56.11$56.11

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $60.53 to $68.10 depending on state and rural status.

StateNon-ruralRural
AK$61.02
AL$61.57
AR$61.57
AZ$60.53
CA$60.53
CO$61.57
CT$61.57
DC$61.57
DE$61.57
FL$61.57
GA$61.57
HI$61.02
IA$60.53
ID$60.53
IL$61.57
IN$61.57
KS$60.53
KY$61.57
LA$61.57
MA$61.57
MD$61.57
ME$61.57
MI$61.57
MN$61.57
MO$61.57
MS$61.57
MT$60.53
NC$61.57
ND$60.53
NE$60.53
NH$61.57
NJ$61.57
NM$61.57
NV$60.53
NY$61.57
OH$61.57
OK$61.57
OR$60.53
PA$61.57
PR$68.10
RI$61.57
SC$61.57
SD$60.53
TN$61.57
TX$61.57
UT$61.57
VA$61.57
VI$61.58
VT$61.57
WA$61.57
WI$61.57
WV$61.57
WY$60.53

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $56.11 to $68.46 depending on state and rural status.

Former-CBA payment limits: ceiling $57.06 · floor $48.50

StateNon-ruralRural
AK$56.11
AL$57.06
AR$57.06
AZ$56.11
CA$56.11
CO$57.06
CT$57.06
DC$57.06
DE$57.06
FL$57.06
GA$57.06
HI$56.11
IA$56.11
ID$56.11
IL$57.06
IN$57.06
KS$56.11
KY$57.06
LA$57.06
MA$57.06
MD$57.06
ME$57.06
MI$57.06
MN$57.06
MO$57.06
MS$57.06
MT$56.11
NC$57.06
ND$56.11
NE$56.11
NH$57.06
NJ$57.06
NM$57.06
NV$56.11
NY$57.06
OH$57.06
OK$57.06
OR$56.11
PA$57.06
PR$68.46
RI$57.06
SC$57.06
SD$56.11
TN$57.06
TX$57.06
UT$57.06
VA$57.06
VI$57.06
VT$57.06
WA$57.06
WI$57.06
WV$57.06
WY$56.11

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $5.11 to $6.30 depending on state and rural status.

StateNon-ruralRural
AK$5.61
AL$5.71$5.71
AR$5.71$5.71
AZ$5.61$5.61
CA$5.61$5.61
CO$5.71$5.71
CT$5.71$5.71
DC$5.71$5.71
DE$5.71$5.71
FL$5.71$5.71
GA$5.71$5.71
HI$5.61
IA$5.61$5.61
ID$5.61$5.61
IL$5.71$5.71
IN$5.71$5.71
KS$5.61$5.61
KY$5.71$5.71
LA$5.71$5.71
MA$5.71$5.71
MD$5.71$5.71
ME$5.71$5.71
MI$5.71$5.71
MN$5.71$5.71
MO$5.71$5.71
MS$5.71$5.71
MT$5.61$5.61
NC$5.71$5.71
ND$5.61$5.61
NE$5.61$5.61
NH$5.71$5.71
NJ$5.71$5.71
NM$5.71$5.71
NV$5.61$5.61
NY$5.71$5.71
OH$5.71$5.71
OK$5.71$5.71
OR$5.61$5.61
PA$5.71$5.71
PR$6.30
RI$5.71$5.71
SC$5.71$5.71
SD$5.61$5.61
TN$5.71$5.71
TX$5.71$5.71
UT$5.11$5.11
VA$5.71$5.71
VI$5.71
VT$5.71$5.71
WA$5.71$5.71
WI$5.71$5.71
WV$5.71$5.71
WY$5.61$5.61

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $5.51 to $6.79 depending on state and rural status.

StateNon-ruralRural
AK$6.10
AL$6.16
AR$6.16
AZ$6.05
CA$6.05
CO$6.16
CT$6.16
DC$6.16
DE$6.16
FL$6.16
GA$6.16
HI$6.10
IA$6.05
ID$6.05
IL$6.16
IN$6.16
KS$6.05
KY$6.16
LA$6.16
MA$6.16
MD$6.16
ME$6.16
MI$6.16
MN$6.16
MO$6.16
MS$6.16
MT$6.05
NC$6.16
ND$6.05
NE$6.05
NH$6.16
NJ$6.16
NM$6.16
NV$6.05
NY$6.16
OH$6.16
OK$6.16
OR$6.05
PA$6.16
PR$6.79
RI$6.16
SC$6.16
SD$6.05
TN$6.16
TX$6.16
UT$5.51
VA$6.16
VI$6.16
VT$6.16
WA$6.16
WI$6.16
WV$6.16
WY$6.05

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $5.10 to $6.82 depending on state and rural status.

Former-CBA payment limits: ceiling $5.71 · floor $4.85

StateNon-ruralRural
AK$5.61
AL$5.71
AR$5.71
AZ$5.61
CA$5.61
CO$5.71
CT$5.71
DC$5.71
DE$5.71
FL$5.71
GA$5.71
HI$5.61
IA$5.61
ID$5.61
IL$5.71
IN$5.71
KS$5.61
KY$5.71
LA$5.71
MA$5.71
MD$5.71
ME$5.71
MI$5.71
MN$5.71
MO$5.71
MS$5.71
MT$5.61
NC$5.71
ND$5.61
NE$5.61
NH$5.71
NJ$5.71
NM$5.71
NV$5.61
NY$5.71
OH$5.71
OK$5.71
OR$5.61
PA$5.71
PR$6.82
RI$5.71
SC$5.71
SD$5.61
TN$5.71
TX$5.71
UT$5.10
VA$5.71
VI$5.71
VT$5.71
WA$5.71
WI$5.71
WV$5.71
WY$5.61

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $42.08 to $47.38 depending on state and rural status.

StateNon-ruralRural
AK$42.08
AL$42.79$42.79
AR$42.79$42.79
AZ$42.08$42.08
CA$42.08$42.08
CO$42.79$42.79
CT$42.79$42.79
DC$42.79$42.79
DE$42.79$42.79
FL$42.79$42.79
GA$42.79$42.79
HI$42.08
IA$42.08$42.08
ID$42.08$42.08
IL$42.79$42.79
IN$42.79$42.79
KS$42.08$42.08
KY$42.79$42.79
LA$42.79$42.79
MA$42.79$42.79
MD$42.79$42.79
ME$42.79$42.79
MI$42.79$42.79
MN$42.79$42.79
MO$42.79$42.79
MS$42.79$42.79
MT$42.08$42.08
NC$42.79$42.79
ND$42.08$42.08
NE$42.08$42.08
NH$42.79$42.79
NJ$42.79$42.79
NM$42.79$42.79
NV$42.08$42.08
NY$42.79$42.79
OH$42.79$42.79
OK$42.79$42.79
OR$42.08$42.08
PA$42.79$42.79
PR$47.38
RI$42.79$42.79
SC$42.79$42.79
SD$42.08$42.08
TN$42.79$42.79
TX$42.79$42.79
UT$42.79$42.79
VA$42.79$42.79
VI$42.79
VT$42.79$42.79
WA$42.79$42.79
WI$42.79$42.79
WV$42.79$42.79
WY$42.08$42.08

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $45.39 to $51.10 depending on state and rural status.

StateNon-ruralRural
AK$45.77
AL$46.17
AR$46.17
AZ$45.39
CA$45.39
CO$46.17
CT$46.17
DC$46.17
DE$46.17
FL$46.17
GA$46.17
HI$45.77
IA$45.39
ID$45.39
IL$46.17
IN$46.17
KS$45.39
KY$46.17
LA$46.17
MA$46.17
MD$46.17
ME$46.17
MI$46.17
MN$46.17
MO$46.17
MS$46.17
MT$45.39
NC$46.17
ND$45.39
NE$45.39
NH$46.17
NJ$46.17
NM$46.17
NV$45.39
NY$46.17
OH$46.17
OK$46.17
OR$45.39
PA$46.17
PR$51.10
RI$46.17
SC$46.17
SD$45.39
TN$46.17
TX$46.17
UT$46.17
VA$46.17
VI$46.18
VT$46.17
WA$46.17
WI$46.17
WV$46.17
WY$45.39

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $42.08 to $51.39 depending on state and rural status.

Former-CBA payment limits: ceiling $42.80 · floor $36.38

StateNon-ruralRural
AK$42.08
AL$42.80
AR$42.80
AZ$42.08
CA$42.08
CO$42.80
CT$42.80
DC$42.80
DE$42.80
FL$42.80
GA$42.80
HI$42.08
IA$42.08
ID$42.08
IL$42.80
IN$42.80
KS$42.08
KY$42.80
LA$42.80
MA$42.80
MD$42.80
ME$42.80
MI$42.80
MN$42.80
MO$42.80
MS$42.80
MT$42.08
NC$42.80
ND$42.08
NE$42.08
NH$42.80
NJ$42.80
NM$42.80
NV$42.08
NY$42.80
OH$42.80
OK$42.80
OR$42.08
PA$42.80
PR$51.39
RI$42.80
SC$42.80
SD$42.08
TN$42.80
TX$42.80
UT$42.80
VA$42.80
VI$42.80
VT$42.80
WA$42.80
WI$42.80
WV$42.80
WY$42.08
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.

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