K0105 — Iv hanger, each
HCPCS Level II K-code · short descriptor: “Iv hanger”
- 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.
K0105 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $115.01 to $154.16 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $138.81 | — |
| AL | $121.11 | $137.63 |
| AR | $121.11 | $137.63 |
| AZ | $120.21 | $136.45 |
| CA | $115.01 | $136.45 |
| CO | $120.46 | $137.63 |
| CT | $126.11 | $137.63 |
| DC | $117.47 | $137.63 |
| DE | $117.47 | $137.63 |
| FL | $121.11 | $137.63 |
| GA | $121.11 | $137.63 |
| HI | $138.81 | — |
| IA | $122.16 | $136.45 |
| ID | $120.46 | $136.45 |
| IL | $127.38 | $137.63 |
| IN | $127.38 | $137.63 |
| KS | $122.16 | $136.45 |
| KY | $121.11 | $137.63 |
| LA | $121.11 | $137.63 |
| MA | $126.11 | $137.63 |
| MD | $117.47 | $137.63 |
| ME | $126.11 | $137.63 |
| MI | $127.38 | $137.63 |
| MN | $122.16 | $137.63 |
| MO | $122.16 | $137.63 |
| MS | $121.11 | $137.63 |
| MT | $120.46 | $136.45 |
| NC | $121.11 | $137.63 |
| ND | $122.16 | $136.45 |
| NE | $122.16 | $136.45 |
| NH | $126.11 | $137.63 |
| NJ | $117.47 | $137.63 |
| NM | $120.21 | $137.63 |
| NV | $115.01 | $136.45 |
| NY | $117.47 | $137.63 |
| OH | $127.38 | $137.63 |
| OK | $120.21 | $137.63 |
| OR | $115.01 | $136.45 |
| PA | $117.47 | $137.63 |
| PR | $154.16 | — |
| RI | $126.11 | $137.63 |
| SC | $121.11 | $137.63 |
| SD | $122.16 | $136.45 |
| TN | $121.11 | $137.63 |
| TX | $120.21 | $137.63 |
| UT | $120.46 | $137.63 |
| VA | $121.11 | $137.63 |
| VI | $140.00 | — |
| VT | $126.11 | $137.63 |
| WA | $115.01 | $137.63 |
| WI | $127.38 | $137.63 |
| WV | $121.11 | $137.63 |
| WY | $120.46 | $136.45 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $139.33 to $170.03 depending on state and rural status.
Former-CBA payment limits: ceiling $141.70 · floor $120.45
| State | Non-rural | Rural |
|---|---|---|
| AK | $139.33 | — |
| AL | $141.70 | — |
| AR | $141.70 | — |
| AZ | $139.33 | — |
| CA | $139.33 | — |
| CO | $141.70 | — |
| CT | $141.70 | — |
| DC | $141.70 | — |
| DE | $141.70 | — |
| FL | $141.70 | — |
| GA | $141.70 | — |
| HI | $139.33 | — |
| IA | $139.33 | — |
| ID | $139.33 | — |
| IL | $141.70 | — |
| IN | $141.70 | — |
| KS | $139.33 | — |
| KY | $141.70 | — |
| LA | $141.70 | — |
| MA | $141.70 | — |
| MD | $141.70 | — |
| ME | $141.70 | — |
| MI | $141.70 | — |
| MN | $141.70 | — |
| MO | $141.70 | — |
| MS | $141.70 | — |
| MT | $139.33 | — |
| NC | $141.70 | — |
| ND | $139.33 | — |
| NE | $139.33 | — |
| NH | $141.70 | — |
| NJ | $141.70 | — |
| NM | $141.70 | — |
| NV | $139.33 | — |
| NY | $141.70 | — |
| OH | $141.70 | — |
| OK | $141.70 | — |
| OR | $139.33 | — |
| PA | $141.70 | — |
| PR | $170.03 | — |
| RI | $141.70 | — |
| SC | $141.70 | — |
| SD | $139.33 | — |
| TN | $141.70 | — |
| TX | $141.70 | — |
| UT | $141.70 | — |
| VA | $141.70 | — |
| VI | $141.70 | — |
| VT | $141.70 | — |
| WA | $141.70 | — |
| WI | $141.70 | — |
| WV | $141.70 | — |
| WY | $139.33 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $11.50 to $15.42 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $13.87 | — |
| AL | $12.11 | $13.76 |
| AR | $12.11 | $13.76 |
| AZ | $12.02 | $13.64 |
| CA | $11.50 | $13.64 |
| CO | $12.05 | $13.76 |
| CT | $12.61 | $13.76 |
| DC | $11.75 | $13.76 |
| DE | $11.75 | $13.76 |
| FL | $12.11 | $13.76 |
| GA | $12.11 | $13.76 |
| HI | $13.87 | — |
| IA | $12.22 | $13.64 |
| ID | $12.05 | $13.64 |
| IL | $12.74 | $13.76 |
| IN | $12.74 | $13.76 |
| KS | $12.22 | $13.64 |
| KY | $12.11 | $13.76 |
| LA | $12.11 | $13.76 |
| MA | $12.61 | $13.76 |
| MD | $11.75 | $13.76 |
| ME | $12.61 | $13.76 |
| MI | $12.74 | $13.76 |
| MN | $12.22 | $13.76 |
| MO | $12.22 | $13.76 |
| MS | $12.11 | $13.76 |
| MT | $12.05 | $13.64 |
| NC | $12.11 | $13.76 |
| ND | $12.22 | $13.64 |
| NE | $12.22 | $13.64 |
| NH | $12.61 | $13.76 |
| NJ | $11.75 | $13.76 |
| NM | $12.02 | $13.76 |
| NV | $11.50 | $13.64 |
| NY | $11.75 | $13.76 |
| OH | $12.74 | $13.76 |
| OK | $12.02 | $13.76 |
| OR | $11.50 | $13.64 |
| PA | $11.75 | $13.76 |
| PR | $15.42 | — |
| RI | $12.61 | $13.76 |
| SC | $12.11 | $13.76 |
| SD | $12.22 | $13.64 |
| TN | $12.11 | $13.76 |
| TX | $12.02 | $13.76 |
| UT | $12.05 | $13.76 |
| VA | $12.11 | $13.76 |
| VI | $14.00 | — |
| VT | $12.61 | $13.76 |
| WA | $11.50 | $13.76 |
| WI | $12.74 | $13.76 |
| WV | $12.11 | $13.76 |
| WY | $12.05 | $13.64 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $13.92 to $17.01 depending on state and rural status.
Former-CBA payment limits: ceiling $14.17 · floor $12.04
| State | Non-rural | Rural |
|---|---|---|
| AK | $13.92 | — |
| AL | $14.17 | — |
| AR | $14.17 | — |
| AZ | $13.92 | — |
| CA | $13.92 | — |
| CO | $14.17 | — |
| CT | $14.17 | — |
| DC | $14.17 | — |
| DE | $14.17 | — |
| FL | $14.17 | — |
| GA | $14.17 | — |
| HI | $13.92 | — |
| IA | $13.92 | — |
| ID | $13.92 | — |
| IL | $14.17 | — |
| IN | $14.17 | — |
| KS | $13.92 | — |
| KY | $14.17 | — |
| LA | $14.17 | — |
| MA | $14.17 | — |
| MD | $14.17 | — |
| ME | $14.17 | — |
| MI | $14.17 | — |
| MN | $14.17 | — |
| MO | $14.17 | — |
| MS | $14.17 | — |
| MT | $13.92 | — |
| NC | $14.17 | — |
| ND | $13.92 | — |
| NE | $13.92 | — |
| NH | $14.17 | — |
| NJ | $14.17 | — |
| NM | $14.17 | — |
| NV | $13.92 | — |
| NY | $14.17 | — |
| OH | $14.17 | — |
| OK | $14.17 | — |
| OR | $13.92 | — |
| PA | $14.17 | — |
| PR | $17.01 | — |
| RI | $14.17 | — |
| SC | $14.17 | — |
| SD | $13.92 | — |
| TN | $14.17 | — |
| TX | $14.17 | — |
| UT | $14.17 | — |
| VA | $14.17 | — |
| VI | $14.17 | — |
| VT | $14.17 | — |
| WA | $14.17 | — |
| WI | $14.17 | — |
| WV | $14.17 | — |
| WY | $13.92 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $86.26 to $115.64 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $104.12 | — |
| AL | $90.83 | $103.23 |
| AR | $90.83 | $103.23 |
| AZ | $90.16 | $102.35 |
| CA | $86.26 | $102.35 |
| CO | $90.34 | $103.23 |
| CT | $94.59 | $103.23 |
| DC | $88.10 | $103.23 |
| DE | $88.10 | $103.23 |
| FL | $90.83 | $103.23 |
| GA | $90.83 | $103.23 |
| HI | $104.12 | — |
| IA | $91.62 | $102.35 |
| ID | $90.34 | $102.35 |
| IL | $95.54 | $103.23 |
| IN | $95.54 | $103.23 |
| KS | $91.62 | $102.35 |
| KY | $90.83 | $103.23 |
| LA | $90.83 | $103.23 |
| MA | $94.59 | $103.23 |
| MD | $88.10 | $103.23 |
| ME | $94.59 | $103.23 |
| MI | $95.54 | $103.23 |
| MN | $91.62 | $103.23 |
| MO | $91.62 | $103.23 |
| MS | $90.83 | $103.23 |
| MT | $90.34 | $102.35 |
| NC | $90.83 | $103.23 |
| ND | $91.62 | $102.35 |
| NE | $91.62 | $102.35 |
| NH | $94.59 | $103.23 |
| NJ | $88.10 | $103.23 |
| NM | $90.16 | $103.23 |
| NV | $86.26 | $102.35 |
| NY | $88.10 | $103.23 |
| OH | $95.54 | $103.23 |
| OK | $90.16 | $103.23 |
| OR | $86.26 | $102.35 |
| PA | $88.10 | $103.23 |
| PR | $115.64 | — |
| RI | $94.59 | $103.23 |
| SC | $90.83 | $103.23 |
| SD | $91.62 | $102.35 |
| TN | $90.83 | $103.23 |
| TX | $90.16 | $103.23 |
| UT | $90.34 | $103.23 |
| VA | $90.83 | $103.23 |
| VI | $105.00 | — |
| VT | $94.59 | $103.23 |
| WA | $86.26 | $103.23 |
| WI | $95.54 | $103.23 |
| WV | $90.83 | $103.23 |
| WY | $90.34 | $102.35 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $104.52 to $127.57 depending on state and rural status.
Former-CBA payment limits: ceiling $106.27 · floor $90.33
| State | Non-rural | Rural |
|---|---|---|
| AK | $104.52 | — |
| AL | $106.27 | — |
| AR | $106.27 | — |
| AZ | $104.52 | — |
| CA | $104.52 | — |
| CO | $106.27 | — |
| CT | $106.27 | — |
| DC | $106.27 | — |
| DE | $106.27 | — |
| FL | $106.27 | — |
| GA | $106.27 | — |
| HI | $104.52 | — |
| IA | $104.52 | — |
| ID | $104.52 | — |
| IL | $106.27 | — |
| IN | $106.27 | — |
| KS | $104.52 | — |
| KY | $106.27 | — |
| LA | $106.27 | — |
| MA | $106.27 | — |
| MD | $106.27 | — |
| ME | $106.27 | — |
| MI | $106.27 | — |
| MN | $106.27 | — |
| MO | $106.27 | — |
| MS | $106.27 | — |
| MT | $104.52 | — |
| NC | $106.27 | — |
| ND | $104.52 | — |
| NE | $104.52 | — |
| NH | $106.27 | — |
| NJ | $106.27 | — |
| NM | $106.27 | — |
| NV | $104.52 | — |
| NY | $106.27 | — |
| OH | $106.27 | — |
| OK | $106.27 | — |
| OR | $104.52 | — |
| PA | $106.27 | — |
| PR | $127.57 | — |
| RI | $106.27 | — |
| SC | $106.27 | — |
| SD | $104.52 | — |
| TN | $106.27 | — |
| TX | $106.27 | — |
| UT | $106.27 | — |
| VA | $106.27 | — |
| VI | $106.27 | — |
| VT | $106.27 | — |
| WA | $106.27 | — |
| WI | $106.27 | — |
| WV | $106.27 | — |
| WY | $104.52 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0105 at 1 unit per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Nature of Equipment.
Common denial codes to watch
Related K-codes
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