MyMedi-AI

K0815 — Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp 1 std seat/back” · PA required

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
Capped rental
Prior authorization
Required (Medicare, since 2018-09-01)
Face-to-face & WOPD
Required (Power Mobility Devices)
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

PA REQUIRED K0815 is on Medicare's DMEPOS Required Prior Authorization List (Power Mobility Devices — nationwide since 2018-09-01).

Claims for this item without an affirmed prior-authorization decision are automatically denied (commonly surfacing as CO-197). Submit the PA request to your DME MAC with the order and supporting clinical documentation 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))

F2F + WOPD REQUIRED K0815 is on Medicare's Required Face-to-Face & WOPD List (Power Mobility Devices — 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)). Two extra conditions of payment apply:

  • Face-to-face encounter (in-person or telehealth) with the treating practitioner within the 6 months before the order date
  • Written order communicated to the supplier before delivery (WOPD)

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

K0815 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $350.06 to $559.30 depending on state and rural status.

StateNon-ruralRural
AK$526.91—
AL$374.57$526.91
AR$374.57$526.91
AZ$376.41$526.91
CA$352.83$526.91
CO$353.75$526.91
CT$367.84$526.91
DC$350.06$526.91
DE$350.06$526.91
FL$374.57$526.91
GA$374.57$526.91
HI$526.91—
IA$400.00$526.91
ID$353.75$526.91
IL$359.21$526.91
IN$359.21$526.91
KS$400.00$526.91
KY$374.57$526.91
LA$374.57$526.91
MA$367.84$526.91
MD$350.06$526.91
ME$367.84$526.91
MI$359.21$526.91
MN$400.00$526.91
MO$400.00$526.91
MS$374.57$526.91
MT$353.75$526.91
NC$374.57$526.91
ND$400.00$526.91
NE$400.00$526.91
NH$367.84$526.91
NJ$350.06$526.91
NM$376.41$526.91
NV$352.83$526.91
NY$350.06$526.91
OH$359.21$526.91
OK$376.41$526.91
OR$352.83$526.91
PA$350.06$526.91
PR$559.30—
RI$367.84$526.91
SC$374.57$526.91
SD$400.00$526.91
TN$374.57$526.91
TX$376.41$526.91
UT$353.75$526.91
VA$374.57$526.91
VI$526.91—
VT$367.84$526.91
WA$352.83$526.91
WI$359.21$526.91
WV$374.57$526.91
WY$353.75$526.91
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 K0815 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 K0815 with confidence

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