K0739 — Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
HCPCS Level II K-code · short descriptor: “Repair/svc dme non-oxygen eq”
- 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
- LT
- Prior authorization
- Not on Medicare required-PA list
- Face-to-face & WOPD
- Not on the required list
- 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.
K0739 Medicare fee schedule (October 2026)
Base (no modifier) LT
Medicare allowable ranges from $20.11 to $37.86 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $37.86 | — |
| AL | $20.11 | — |
| AR | $20.11 | — |
| AZ | $24.86 | — |
| CA | $30.86 | — |
| CO | $20.11 | — |
| CT | $33.57 | — |
| DC | $20.11 | — |
| DE | $37.01 | — |
| FL | $20.11 | — |
| GA | $20.11 | — |
| HI | $24.86 | — |
| IA | $20.11 | — |
| ID | $20.11 | — |
| IL | $20.11 | — |
| IN | $20.11 | — |
| KS | $20.11 | — |
| KY | $20.11 | — |
| LA | $20.11 | — |
| MA | $33.57 | — |
| MD | $20.11 | — |
| ME | $33.57 | — |
| MI | $20.11 | — |
| MN | $20.11 | — |
| MO | $20.11 | — |
| MS | $20.11 | — |
| MT | $20.11 | — |
| NC | $20.11 | — |
| ND | $25.06 | — |
| NE | $20.11 | — |
| NH | $21.59 | — |
| NJ | $27.13 | — |
| NM | $20.11 | — |
| NV | $32.02 | — |
| NY | $37.01 | — |
| OH | $20.11 | — |
| OK | $20.11 | — |
| OR | $20.11 | — |
| PA | $21.59 | — |
| PR | $20.11 | — |
| RI | $23.96 | — |
| SC | $20.11 | — |
| SD | $22.48 | — |
| TN | $20.11 | — |
| TX | $20.11 | — |
| UT | $20.16 | — |
| VA | $20.11 | — |
| VI | $20.11 | — |
| VT | $21.59 | — |
| WA | $32.02 | — |
| WI | $20.11 | — |
| WV | $20.11 | — |
| WY | $28.05 | — |
Common denial codes to watch
Related K-codes
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