K0056 — Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair
HCPCS Level II K-code · short descriptor: “Seat ht <17 or >=21 ltwt wc”
- 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
- 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))
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.
K0056 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $108.75 to $147.27 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $132.57 | — |
| AL | $117.03 | $130.93 |
| AR | $117.03 | $130.93 |
| AZ | $111.14 | $129.78 |
| CA | $110.04 | $129.78 |
| CO | $118.55 | $130.93 |
| CT | $113.33 | $130.93 |
| DC | $108.75 | $130.93 |
| DE | $108.75 | $130.93 |
| FL | $117.03 | $130.93 |
| GA | $117.03 | $130.93 |
| HI | $132.57 | — |
| IA | $117.22 | $129.78 |
| ID | $118.55 | $129.78 |
| IL | $118.43 | $130.93 |
| IN | $118.43 | $130.93 |
| KS | $117.22 | $129.78 |
| KY | $117.03 | $130.93 |
| LA | $117.03 | $130.93 |
| MA | $113.33 | $130.93 |
| MD | $108.75 | $130.93 |
| ME | $113.33 | $130.93 |
| MI | $118.43 | $130.93 |
| MN | $117.22 | $130.93 |
| MO | $117.22 | $130.93 |
| MS | $117.03 | $130.93 |
| MT | $118.55 | $129.78 |
| NC | $117.03 | $130.93 |
| ND | $117.22 | $129.78 |
| NE | $117.22 | $129.78 |
| NH | $113.33 | $130.93 |
| NJ | $108.75 | $130.93 |
| NM | $111.14 | $130.93 |
| NV | $110.04 | $129.78 |
| NY | $108.75 | $130.93 |
| OH | $118.43 | $130.93 |
| OK | $111.14 | $130.93 |
| OR | $110.04 | $129.78 |
| PA | $108.75 | $130.93 |
| PR | $147.27 | — |
| RI | $113.33 | $130.93 |
| SC | $117.03 | $130.93 |
| SD | $117.22 | $129.78 |
| TN | $117.03 | $130.93 |
| TX | $111.14 | $130.93 |
| UT | $118.55 | $130.93 |
| VA | $117.03 | $130.93 |
| VI | $133.72 | — |
| VT | $113.33 | $130.93 |
| WA | $110.04 | $129.78 |
| WI | $118.43 | $130.93 |
| WV | $117.03 | $130.93 |
| WY | $118.55 | $129.78 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $133.23 to $162.64 depending on state and rural status.
Former-CBA payment limits: ceiling $135.54 · floor $115.21
| State | Non-rural | Rural |
|---|---|---|
| AK | $133.23 | — |
| AL | $135.54 | — |
| AR | $135.54 | — |
| AZ | $133.23 | — |
| CA | $133.23 | — |
| CO | $135.54 | — |
| CT | $135.54 | — |
| DC | $135.54 | — |
| DE | $135.54 | — |
| FL | $135.54 | — |
| GA | $135.54 | — |
| HI | $133.23 | — |
| IA | $133.23 | — |
| ID | $133.23 | — |
| IL | $135.54 | — |
| IN | $135.54 | — |
| KS | $133.23 | — |
| KY | $135.54 | — |
| LA | $135.54 | — |
| MA | $135.54 | — |
| MD | $135.54 | — |
| ME | $135.54 | — |
| MI | $135.54 | — |
| MN | $135.54 | — |
| MO | $135.54 | — |
| MS | $135.54 | — |
| MT | $133.23 | — |
| NC | $135.54 | — |
| ND | $133.23 | — |
| NE | $133.23 | — |
| NH | $135.54 | — |
| NJ | $135.54 | — |
| NM | $135.54 | — |
| NV | $133.23 | — |
| NY | $135.54 | — |
| OH | $135.54 | — |
| OK | $135.54 | — |
| OR | $133.23 | — |
| PA | $135.54 | — |
| PR | $162.64 | — |
| RI | $135.54 | — |
| SC | $135.54 | — |
| SD | $133.23 | — |
| TN | $135.54 | — |
| TX | $135.54 | — |
| UT | $135.54 | — |
| VA | $135.54 | — |
| VI | $135.54 | — |
| VT | $135.54 | — |
| WA | $133.23 | — |
| WI | $135.54 | — |
| WV | $135.54 | — |
| WY | $133.23 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $10.88 to $14.72 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $13.27 | — |
| AL | $11.70 | $13.10 |
| AR | $11.70 | $13.10 |
| AZ | $11.12 | $12.99 |
| CA | $11.01 | $12.99 |
| CO | $11.86 | $13.10 |
| CT | $11.33 | $13.10 |
| DC | $10.88 | $13.10 |
| DE | $10.88 | $13.10 |
| FL | $11.70 | $13.10 |
| GA | $11.70 | $13.10 |
| HI | $13.27 | — |
| IA | $11.72 | $12.99 |
| ID | $11.86 | $12.99 |
| IL | $11.84 | $13.10 |
| IN | $11.84 | $13.10 |
| KS | $11.72 | $12.99 |
| KY | $11.70 | $13.10 |
| LA | $11.70 | $13.10 |
| MA | $11.33 | $13.10 |
| MD | $10.88 | $13.10 |
| ME | $11.33 | $13.10 |
| MI | $11.84 | $13.10 |
| MN | $11.72 | $13.10 |
| MO | $11.72 | $13.10 |
| MS | $11.70 | $13.10 |
| MT | $11.86 | $12.99 |
| NC | $11.70 | $13.10 |
| ND | $11.72 | $12.99 |
| NE | $11.72 | $12.99 |
| NH | $11.33 | $13.10 |
| NJ | $10.88 | $13.10 |
| NM | $11.12 | $13.10 |
| NV | $11.01 | $12.99 |
| NY | $10.88 | $13.10 |
| OH | $11.84 | $13.10 |
| OK | $11.12 | $13.10 |
| OR | $11.01 | $12.99 |
| PA | $10.88 | $13.10 |
| PR | $14.72 | — |
| RI | $11.33 | $13.10 |
| SC | $11.70 | $13.10 |
| SD | $11.72 | $12.99 |
| TN | $11.70 | $13.10 |
| TX | $11.12 | $13.10 |
| UT | $11.86 | $13.10 |
| VA | $11.70 | $13.10 |
| VI | $13.37 | — |
| VT | $11.33 | $13.10 |
| WA | $11.01 | $12.99 |
| WI | $11.84 | $13.10 |
| WV | $11.70 | $13.10 |
| WY | $11.86 | $12.99 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $13.34 to $16.27 depending on state and rural status.
Former-CBA payment limits: ceiling $13.57 · floor $11.53
| State | Non-rural | Rural |
|---|---|---|
| AK | $13.34 | — |
| AL | $13.57 | — |
| AR | $13.57 | — |
| AZ | $13.34 | — |
| CA | $13.34 | — |
| CO | $13.57 | — |
| CT | $13.57 | — |
| DC | $13.57 | — |
| DE | $13.57 | — |
| FL | $13.57 | — |
| GA | $13.57 | — |
| HI | $13.34 | — |
| IA | $13.34 | — |
| ID | $13.34 | — |
| IL | $13.57 | — |
| IN | $13.57 | — |
| KS | $13.34 | — |
| KY | $13.57 | — |
| LA | $13.57 | — |
| MA | $13.57 | — |
| MD | $13.57 | — |
| ME | $13.57 | — |
| MI | $13.57 | — |
| MN | $13.57 | — |
| MO | $13.57 | — |
| MS | $13.57 | — |
| MT | $13.34 | — |
| NC | $13.57 | — |
| ND | $13.34 | — |
| NE | $13.34 | — |
| NH | $13.57 | — |
| NJ | $13.57 | — |
| NM | $13.57 | — |
| NV | $13.34 | — |
| NY | $13.57 | — |
| OH | $13.57 | — |
| OK | $13.57 | — |
| OR | $13.34 | — |
| PA | $13.57 | — |
| PR | $16.27 | — |
| RI | $13.57 | — |
| SC | $13.57 | — |
| SD | $13.34 | — |
| TN | $13.57 | — |
| TX | $13.57 | — |
| UT | $13.57 | — |
| VA | $13.57 | — |
| VI | $13.57 | — |
| VT | $13.57 | — |
| WA | $13.34 | — |
| WI | $13.57 | — |
| WV | $13.57 | — |
| WY | $13.34 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $81.57 to $110.44 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $99.45 | — |
| AL | $87.77 | $98.21 |
| AR | $87.77 | $98.21 |
| AZ | $83.36 | $97.36 |
| CA | $82.54 | $97.36 |
| CO | $88.91 | $98.21 |
| CT | $85.00 | $98.21 |
| DC | $81.57 | $98.21 |
| DE | $81.57 | $98.21 |
| FL | $87.77 | $98.21 |
| GA | $87.77 | $98.21 |
| HI | $99.45 | — |
| IA | $87.92 | $97.36 |
| ID | $88.91 | $97.36 |
| IL | $88.82 | $98.21 |
| IN | $88.82 | $98.21 |
| KS | $87.92 | $97.36 |
| KY | $87.77 | $98.21 |
| LA | $87.77 | $98.21 |
| MA | $85.00 | $98.21 |
| MD | $81.57 | $98.21 |
| ME | $85.00 | $98.21 |
| MI | $88.82 | $98.21 |
| MN | $87.92 | $98.21 |
| MO | $87.92 | $98.21 |
| MS | $87.77 | $98.21 |
| MT | $88.91 | $97.36 |
| NC | $87.77 | $98.21 |
| ND | $87.92 | $97.36 |
| NE | $87.92 | $97.36 |
| NH | $85.00 | $98.21 |
| NJ | $81.57 | $98.21 |
| NM | $83.36 | $98.21 |
| NV | $82.54 | $97.36 |
| NY | $81.57 | $98.21 |
| OH | $88.82 | $98.21 |
| OK | $83.36 | $98.21 |
| OR | $82.54 | $97.36 |
| PA | $81.57 | $98.21 |
| PR | $110.44 | — |
| RI | $85.00 | $98.21 |
| SC | $87.77 | $98.21 |
| SD | $87.92 | $97.36 |
| TN | $87.77 | $98.21 |
| TX | $83.36 | $98.21 |
| UT | $88.91 | $98.21 |
| VA | $87.77 | $98.21 |
| VI | $100.30 | — |
| VT | $85.00 | $98.21 |
| WA | $82.54 | $97.36 |
| WI | $88.82 | $98.21 |
| WV | $87.77 | $98.21 |
| WY | $88.91 | $97.36 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $100.00 to $121.97 depending on state and rural status.
Former-CBA payment limits: ceiling $101.68 · floor $86.43
| State | Non-rural | Rural |
|---|---|---|
| AK | $100.00 | — |
| AL | $101.68 | — |
| AR | $101.68 | — |
| AZ | $100.00 | — |
| CA | $100.00 | — |
| CO | $101.68 | — |
| CT | $101.68 | — |
| DC | $101.68 | — |
| DE | $101.68 | — |
| FL | $101.68 | — |
| GA | $101.68 | — |
| HI | $100.00 | — |
| IA | $100.00 | — |
| ID | $100.00 | — |
| IL | $101.68 | — |
| IN | $101.68 | — |
| KS | $100.00 | — |
| KY | $101.68 | — |
| LA | $101.68 | — |
| MA | $101.68 | — |
| MD | $101.68 | — |
| ME | $101.68 | — |
| MI | $101.68 | — |
| MN | $101.68 | — |
| MO | $101.68 | — |
| MS | $101.68 | — |
| MT | $100.00 | — |
| NC | $101.68 | — |
| ND | $100.00 | — |
| NE | $100.00 | — |
| NH | $101.68 | — |
| NJ | $101.68 | — |
| NM | $101.68 | — |
| NV | $100.00 | — |
| NY | $101.68 | — |
| OH | $101.68 | — |
| OK | $101.68 | — |
| OR | $100.00 | — |
| PA | $101.68 | — |
| PR | $121.97 | — |
| RI | $101.68 | — |
| SC | $101.68 | — |
| SD | $100.00 | — |
| TN | $101.68 | — |
| TX | $101.68 | — |
| UT | $101.68 | — |
| VA | $101.68 | — |
| VI | $101.68 | — |
| VT | $101.68 | — |
| WA | $100.00 | — |
| WI | $101.68 | — |
| WV | $101.68 | — |
| WY | $100.00 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0056 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
Bill K0056 with confidence
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