MyMedi-AI

K0609 — Replacement electrodes for use with automated external defibrillator, garment type only, each

HCPCS Level II K-code · short descriptor: “Repl electrode for aed”

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
Supplies
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.

K0609 Medicare fee schedule (October 2026)

Base (no modifier) Supplies

Medicare allowable ranges from $1148.78 to $1378.59 depending on state and rural status.

Former-CBA payment limits: ceiling $1148.78 · floor $976.46

StateNon-ruralRural
AK$1148.78—
AL$1148.78—
AR$1148.78—
AZ$1148.78—
CA$1148.78—
CO$1148.78—
CT$1148.78—
DC$1148.78—
DE$1148.78—
FL$1148.78—
GA$1148.78—
HI$1148.78—
IA$1148.78—
ID$1148.78—
IL$1148.78—
IN$1148.78—
KS$1148.78—
KY$1148.78—
LA$1148.78—
MA$1148.78—
MD$1148.78—
ME$1148.78—
MI$1148.78—
MN$1148.78—
MO$1148.78—
MS$1148.78—
MT$1148.78—
NC$1148.78—
ND$1148.78—
NE$1148.78—
NH$1148.78—
NJ$1148.78—
NM$1148.78—
NV$1148.78—
NY$1148.78—
OH$1148.78—
OK$1148.78—
OR$1148.78—
PA$1148.78—
PR$1378.59—
RI$1148.78—
SC$1148.78—
SD$1148.78—
TN$1148.78—
TX$1148.78—
UT$1148.78—
VA$1148.78—
VI$1148.78—
VT$1148.78—
WA$1148.78—
WI$1148.78—
WV$1148.78—
WY$1148.78—

KF Supplies

Medicare allowable ranges from $1275.45 to $1530.56 depending on state and rural status.

Former-CBA payment limits: ceiling $1275.45 · floor $1084.13

StateNon-ruralRural
AK$1275.45—
AL$1275.45—
AR$1275.45—
AZ$1275.45—
CA$1275.45—
CO$1275.45—
CT$1275.45—
DC$1275.45—
DE$1275.45—
FL$1275.45—
GA$1275.45—
HI$1275.45—
IA$1275.45—
ID$1275.45—
IL$1275.45—
IN$1275.45—
KS$1275.45—
KY$1275.45—
LA$1275.45—
MA$1275.45—
MD$1275.45—
ME$1275.45—
MI$1275.45—
MN$1275.45—
MO$1275.45—
MS$1275.45—
MT$1275.45—
NC$1275.45—
ND$1275.45—
NE$1275.45—
NH$1275.45—
NJ$1275.45—
NM$1275.45—
NV$1275.45—
NY$1275.45—
OH$1275.45—
OK$1275.45—
OR$1275.45—
PA$1275.45—
PR$1530.56—
RI$1275.45—
SC$1275.45—
SD$1275.45—
TN$1275.45—
TX$1275.45—
UT$1275.45—
VA$1275.45—
VI$1275.45—
VT$1275.45—
WA$1275.45—
WI$1275.45—
WV$1275.45—
WY$1275.45—
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 K0609 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

CO-50 medical necessityCO-151 frequency/units

Related K-codes

K0601K0602K0603K0604K0605K0606K0607K0608K0669K0672

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