K0039 — Leg strap, h style, each
HCPCS Level II K-code · short descriptor: “Leg strap h style each”
- 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
- 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.
K0039 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $63.32 to $71.37 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $64.20 | — |
| AL | $63.32 | $64.75 |
| AR | $63.32 | $64.75 |
| AZ | $63.32 | $64.20 |
| CA | $63.32 | $64.20 |
| CO | $63.32 | $64.75 |
| CT | $63.32 | $64.75 |
| DC | $63.32 | $64.75 |
| DE | $63.32 | $64.75 |
| FL | $63.32 | $64.75 |
| GA | $63.32 | $64.75 |
| HI | $64.20 | — |
| IA | $63.32 | $64.20 |
| ID | $63.32 | $64.20 |
| IL | $63.32 | $64.75 |
| IN | $63.32 | $64.75 |
| KS | $63.32 | $64.20 |
| KY | $63.32 | $64.75 |
| LA | $63.32 | $64.75 |
| MA | $63.32 | $64.75 |
| MD | $63.32 | $64.75 |
| ME | $63.32 | $64.75 |
| MI | $63.32 | $64.75 |
| MN | $63.32 | $64.75 |
| MO | $63.32 | $64.75 |
| MS | $63.32 | $64.75 |
| MT | $63.32 | $64.20 |
| NC | $63.32 | $64.75 |
| ND | $63.32 | $64.20 |
| NE | $63.32 | $64.20 |
| NH | $63.32 | $64.75 |
| NJ | $63.32 | $64.75 |
| NM | $63.32 | $64.75 |
| NV | $63.32 | $64.20 |
| NY | $63.32 | $64.75 |
| OH | $63.32 | $64.75 |
| OK | $63.32 | $64.75 |
| OR | $63.32 | $64.20 |
| PA | $63.32 | $64.75 |
| PR | $71.37 | — |
| RI | $63.32 | $64.75 |
| SC | $63.32 | $64.75 |
| SD | $63.32 | $64.20 |
| TN | $63.32 | $64.75 |
| TX | $63.32 | $64.75 |
| UT | $63.32 | $64.75 |
| VA | $63.32 | $64.75 |
| VI | $64.75 | — |
| VT | $63.32 | $64.75 |
| WA | $63.32 | $64.75 |
| WI | $63.32 | $64.75 |
| WV | $63.32 | $64.75 |
| WY | $63.32 | $64.20 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $68.92 to $77.13 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $68.92 | — |
| AL | — | $69.54 |
| AR | — | $69.54 |
| AZ | — | $68.92 |
| CA | — | $68.92 |
| CO | — | $69.54 |
| CT | — | $69.54 |
| DC | — | $69.54 |
| DE | — | $69.54 |
| FL | — | $69.54 |
| GA | — | $69.54 |
| HI | $68.92 | — |
| IA | — | $68.92 |
| ID | — | $68.92 |
| IL | — | $69.54 |
| IN | — | $69.54 |
| KS | — | $68.92 |
| KY | — | $69.54 |
| LA | — | $69.54 |
| MA | — | $69.54 |
| MD | — | $69.54 |
| ME | — | $69.54 |
| MI | — | $69.54 |
| MN | — | $69.54 |
| MO | — | $69.54 |
| MS | — | $69.54 |
| MT | — | $68.92 |
| NC | — | $69.54 |
| ND | — | $68.92 |
| NE | — | $68.92 |
| NH | — | $69.54 |
| NJ | — | $69.54 |
| NM | — | $69.54 |
| NV | — | $68.92 |
| NY | — | $69.54 |
| OH | — | $69.54 |
| OK | — | $69.54 |
| OR | — | $68.92 |
| PA | — | $69.54 |
| PR | $77.13 | — |
| RI | — | $69.54 |
| SC | — | $69.54 |
| SD | — | $68.92 |
| TN | — | $69.54 |
| TX | — | $69.54 |
| UT | — | $69.54 |
| VA | — | $69.54 |
| VI | $69.54 | — |
| VT | — | $69.54 |
| WA | — | $69.54 |
| WI | — | $69.54 |
| WV | — | $69.54 |
| WY | — | $68.92 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $65.09 to $79.42 depending on state and rural status.
Former-CBA payment limits: ceiling $66.18 · floor $56.25
| State | Non-rural | Rural |
|---|---|---|
| AK | $65.09 | — |
| AL | $66.18 | — |
| AR | $66.18 | — |
| AZ | $65.09 | — |
| CA | $65.09 | — |
| CO | $66.18 | — |
| CT | $66.18 | — |
| DC | $66.18 | — |
| DE | $66.18 | — |
| FL | $66.18 | — |
| GA | $66.18 | — |
| HI | $65.09 | — |
| IA | $65.09 | — |
| ID | $65.09 | — |
| IL | $66.18 | — |
| IN | $66.18 | — |
| KS | $65.09 | — |
| KY | $66.18 | — |
| LA | $66.18 | — |
| MA | $66.18 | — |
| MD | $66.18 | — |
| ME | $66.18 | — |
| MI | $66.18 | — |
| MN | $66.18 | — |
| MO | $66.18 | — |
| MS | $66.18 | — |
| MT | $65.09 | — |
| NC | $66.18 | — |
| ND | $65.09 | — |
| NE | $65.09 | — |
| NH | $66.18 | — |
| NJ | $66.18 | — |
| NM | $66.18 | — |
| NV | $65.09 | — |
| NY | $66.18 | — |
| OH | $66.18 | — |
| OK | $66.18 | — |
| OR | $65.09 | — |
| PA | $66.18 | — |
| PR | $79.42 | — |
| RI | $66.18 | — |
| SC | $66.18 | — |
| SD | $65.09 | — |
| TN | $66.18 | — |
| TX | $66.18 | — |
| UT | $66.18 | — |
| VA | $66.18 | — |
| VI | $66.18 | — |
| VT | $66.18 | — |
| WA | $66.18 | — |
| WI | $66.18 | — |
| WV | $66.18 | — |
| WY | $65.09 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.33 to $7.14 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.44 | — |
| AL | $6.33 | $6.49 |
| AR | $6.33 | $6.49 |
| AZ | $6.33 | $6.44 |
| CA | $6.33 | $6.44 |
| CO | $6.33 | $6.49 |
| CT | $6.33 | $6.49 |
| DC | $6.33 | $6.49 |
| DE | $6.33 | $6.49 |
| FL | $6.33 | $6.49 |
| GA | $6.33 | $6.49 |
| HI | $6.44 | — |
| IA | $6.33 | $6.44 |
| ID | $6.33 | $6.44 |
| IL | $6.33 | $6.49 |
| IN | $6.33 | $6.49 |
| KS | $6.33 | $6.44 |
| KY | $6.33 | $6.49 |
| LA | $6.33 | $6.49 |
| MA | $6.33 | $6.49 |
| MD | $6.33 | $6.49 |
| ME | $6.33 | $6.49 |
| MI | $6.33 | $6.49 |
| MN | $6.33 | $6.49 |
| MO | $6.33 | $6.49 |
| MS | $6.33 | $6.49 |
| MT | $6.33 | $6.44 |
| NC | $6.33 | $6.49 |
| ND | $6.33 | $6.44 |
| NE | $6.33 | $6.44 |
| NH | $6.33 | $6.49 |
| NJ | $6.33 | $6.49 |
| NM | $6.33 | $6.49 |
| NV | $6.33 | $6.44 |
| NY | $6.33 | $6.49 |
| OH | $6.33 | $6.49 |
| OK | $6.33 | $6.49 |
| OR | $6.33 | $6.44 |
| PA | $6.33 | $6.49 |
| PR | $7.14 | — |
| RI | $6.33 | $6.49 |
| SC | $6.33 | $6.49 |
| SD | $6.33 | $6.44 |
| TN | $6.33 | $6.49 |
| TX | $6.33 | $6.49 |
| UT | $6.33 | $6.49 |
| VA | $6.33 | $6.49 |
| VI | $6.49 | — |
| VT | $6.33 | $6.49 |
| WA | $6.33 | $6.49 |
| WI | $6.33 | $6.49 |
| WV | $6.33 | $6.49 |
| WY | $6.33 | $6.44 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.91 to $7.72 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.91 | — |
| AL | — | $6.97 |
| AR | — | $6.97 |
| AZ | — | $6.91 |
| CA | — | $6.91 |
| CO | — | $6.97 |
| CT | — | $6.97 |
| DC | — | $6.97 |
| DE | — | $6.97 |
| FL | — | $6.97 |
| GA | — | $6.97 |
| HI | $6.91 | — |
| IA | — | $6.91 |
| ID | — | $6.91 |
| IL | — | $6.97 |
| IN | — | $6.97 |
| KS | — | $6.91 |
| KY | — | $6.97 |
| LA | — | $6.97 |
| MA | — | $6.97 |
| MD | — | $6.97 |
| ME | — | $6.97 |
| MI | — | $6.97 |
| MN | — | $6.97 |
| MO | — | $6.97 |
| MS | — | $6.97 |
| MT | — | $6.91 |
| NC | — | $6.97 |
| ND | — | $6.91 |
| NE | — | $6.91 |
| NH | — | $6.97 |
| NJ | — | $6.97 |
| NM | — | $6.97 |
| NV | — | $6.91 |
| NY | — | $6.97 |
| OH | — | $6.97 |
| OK | — | $6.97 |
| OR | — | $6.91 |
| PA | — | $6.97 |
| PR | $7.72 | — |
| RI | — | $6.97 |
| SC | — | $6.97 |
| SD | — | $6.91 |
| TN | — | $6.97 |
| TX | — | $6.97 |
| UT | — | $6.97 |
| VA | — | $6.97 |
| VI | $6.97 | — |
| VT | — | $6.97 |
| WA | — | $6.97 |
| WI | — | $6.97 |
| WV | — | $6.97 |
| WY | — | $6.91 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.56 to $7.94 depending on state and rural status.
Former-CBA payment limits: ceiling $6.66 · floor $5.66
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.56 | — |
| AL | $6.66 | — |
| AR | $6.66 | — |
| AZ | $6.56 | — |
| CA | $6.56 | — |
| CO | $6.66 | — |
| CT | $6.66 | — |
| DC | $6.66 | — |
| DE | $6.66 | — |
| FL | $6.66 | — |
| GA | $6.66 | — |
| HI | $6.56 | — |
| IA | $6.56 | — |
| ID | $6.56 | — |
| IL | $6.66 | — |
| IN | $6.66 | — |
| KS | $6.56 | — |
| KY | $6.66 | — |
| LA | $6.66 | — |
| MA | $6.66 | — |
| MD | $6.66 | — |
| ME | $6.66 | — |
| MI | $6.66 | — |
| MN | $6.66 | — |
| MO | $6.66 | — |
| MS | $6.66 | — |
| MT | $6.56 | — |
| NC | $6.66 | — |
| ND | $6.56 | — |
| NE | $6.56 | — |
| NH | $6.66 | — |
| NJ | $6.66 | — |
| NM | $6.66 | — |
| NV | $6.56 | — |
| NY | $6.66 | — |
| OH | $6.66 | — |
| OK | $6.66 | — |
| OR | $6.56 | — |
| PA | $6.66 | — |
| PR | $7.94 | — |
| RI | $6.66 | — |
| SC | $6.66 | — |
| SD | $6.56 | — |
| TN | $6.66 | — |
| TX | $6.66 | — |
| UT | $6.66 | — |
| VA | $6.66 | — |
| VI | $6.66 | — |
| VT | $6.66 | — |
| WA | $6.66 | — |
| WI | $6.66 | — |
| WV | $6.66 | — |
| WY | $6.56 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $47.49 to $53.54 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $48.14 | — |
| AL | $47.49 | $48.56 |
| AR | $47.49 | $48.56 |
| AZ | $47.49 | $48.14 |
| CA | $47.49 | $48.14 |
| CO | $47.49 | $48.56 |
| CT | $47.49 | $48.56 |
| DC | $47.49 | $48.56 |
| DE | $47.49 | $48.56 |
| FL | $47.49 | $48.56 |
| GA | $47.49 | $48.56 |
| HI | $48.14 | — |
| IA | $47.49 | $48.14 |
| ID | $47.49 | $48.14 |
| IL | $47.49 | $48.56 |
| IN | $47.49 | $48.56 |
| KS | $47.49 | $48.14 |
| KY | $47.49 | $48.56 |
| LA | $47.49 | $48.56 |
| MA | $47.49 | $48.56 |
| MD | $47.49 | $48.56 |
| ME | $47.49 | $48.56 |
| MI | $47.49 | $48.56 |
| MN | $47.49 | $48.56 |
| MO | $47.49 | $48.56 |
| MS | $47.49 | $48.56 |
| MT | $47.49 | $48.14 |
| NC | $47.49 | $48.56 |
| ND | $47.49 | $48.14 |
| NE | $47.49 | $48.14 |
| NH | $47.49 | $48.56 |
| NJ | $47.49 | $48.56 |
| NM | $47.49 | $48.56 |
| NV | $47.49 | $48.14 |
| NY | $47.49 | $48.56 |
| OH | $47.49 | $48.56 |
| OK | $47.49 | $48.56 |
| OR | $47.49 | $48.14 |
| PA | $47.49 | $48.56 |
| PR | $53.54 | — |
| RI | $47.49 | $48.56 |
| SC | $47.49 | $48.56 |
| SD | $47.49 | $48.14 |
| TN | $47.49 | $48.56 |
| TX | $47.49 | $48.56 |
| UT | $47.49 | $48.56 |
| VA | $47.49 | $48.56 |
| VI | $48.56 | — |
| VT | $47.49 | $48.56 |
| WA | $47.49 | $48.56 |
| WI | $47.49 | $48.56 |
| WV | $47.49 | $48.56 |
| WY | $47.49 | $48.14 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $51.68 to $57.86 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $51.68 | — |
| AL | — | $52.16 |
| AR | — | $52.16 |
| AZ | — | $51.68 |
| CA | — | $51.68 |
| CO | — | $52.16 |
| CT | — | $52.16 |
| DC | — | $52.16 |
| DE | — | $52.16 |
| FL | — | $52.16 |
| GA | — | $52.16 |
| HI | $51.68 | — |
| IA | — | $51.68 |
| ID | — | $51.68 |
| IL | — | $52.16 |
| IN | — | $52.16 |
| KS | — | $51.68 |
| KY | — | $52.16 |
| LA | — | $52.16 |
| MA | — | $52.16 |
| MD | — | $52.16 |
| ME | — | $52.16 |
| MI | — | $52.16 |
| MN | — | $52.16 |
| MO | — | $52.16 |
| MS | — | $52.16 |
| MT | — | $51.68 |
| NC | — | $52.16 |
| ND | — | $51.68 |
| NE | — | $51.68 |
| NH | — | $52.16 |
| NJ | — | $52.16 |
| NM | — | $52.16 |
| NV | — | $51.68 |
| NY | — | $52.16 |
| OH | — | $52.16 |
| OK | — | $52.16 |
| OR | — | $51.68 |
| PA | — | $52.16 |
| PR | $57.86 | — |
| RI | — | $52.16 |
| SC | — | $52.16 |
| SD | — | $51.68 |
| TN | — | $52.16 |
| TX | — | $52.16 |
| UT | — | $52.16 |
| VA | — | $52.16 |
| VI | $52.16 | — |
| VT | — | $52.16 |
| WA | — | $52.16 |
| WI | — | $52.16 |
| WV | — | $52.16 |
| WY | — | $51.68 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $48.78 to $59.58 depending on state and rural status.
Former-CBA payment limits: ceiling $49.64 · floor $42.19
| State | Non-rural | Rural |
|---|---|---|
| AK | $48.78 | — |
| AL | $49.64 | — |
| AR | $49.64 | — |
| AZ | $48.78 | — |
| CA | $48.78 | — |
| CO | $49.64 | — |
| CT | $49.64 | — |
| DC | $49.64 | — |
| DE | $49.64 | — |
| FL | $49.64 | — |
| GA | $49.64 | — |
| HI | $48.78 | — |
| IA | $48.78 | — |
| ID | $48.78 | — |
| IL | $49.64 | — |
| IN | $49.64 | — |
| KS | $48.78 | — |
| KY | $49.64 | — |
| LA | $49.64 | — |
| MA | $49.64 | — |
| MD | $49.64 | — |
| ME | $49.64 | — |
| MI | $49.64 | — |
| MN | $49.64 | — |
| MO | $49.64 | — |
| MS | $49.64 | — |
| MT | $48.78 | — |
| NC | $49.64 | — |
| ND | $48.78 | — |
| NE | $48.78 | — |
| NH | $49.64 | — |
| NJ | $49.64 | — |
| NM | $49.64 | — |
| NV | $48.78 | — |
| NY | $49.64 | — |
| OH | $49.64 | — |
| OK | $49.64 | — |
| OR | $48.78 | — |
| PA | $49.64 | — |
| PR | $59.58 | — |
| RI | $49.64 | — |
| SC | $49.64 | — |
| SD | $48.78 | — |
| TN | $49.64 | — |
| TX | $49.64 | — |
| UT | $49.64 | — |
| VA | $49.64 | — |
| VI | $49.64 | — |
| VT | $49.64 | — |
| WA | $49.64 | — |
| WI | $49.64 | — |
| WV | $49.64 | — |
| WY | $48.78 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0039 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.
Common denial codes to watch
Related K-codes
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