MyMedi-AI

K0823 — Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp 2 std cap chair” · 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 K0823 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 K0823 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.

K0823 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $328.10 to $596.48 depending on state and rural status.

StateNon-ruralRural
AK$559.39—
AL$350.31$559.39
AR$350.31$559.39
AZ$346.05$559.39
CA$344.95$559.39
CO$342.07$559.39
CT$328.22$559.39
DC$328.10$559.39
DE$328.10$559.39
FL$350.31$559.39
GA$350.31$559.39
HI$559.39—
IA$353.74$559.39
ID$342.07$559.39
IL$343.79$559.39
IN$343.79$559.39
KS$353.74$559.39
KY$350.31$559.39
LA$350.31$559.39
MA$328.22$559.39
MD$328.10$559.39
ME$328.22$559.39
MI$343.79$559.39
MN$353.74$559.39
MO$353.74$559.39
MS$350.31$559.39
MT$342.07$559.39
NC$350.31$559.39
ND$353.74$559.39
NE$353.74$559.39
NH$328.22$559.39
NJ$328.10$559.39
NM$346.05$559.39
NV$344.95$559.39
NY$328.10$559.39
OH$343.79$559.39
OK$346.05$559.39
OR$344.95$559.39
PA$328.10$559.39
PR$596.48—
RI$328.22$559.39
SC$350.31$559.39
SD$353.74$559.39
TN$350.31$559.39
TX$346.05$559.39
UT$342.07$559.39
VA$350.31$559.39
VI$559.39—
VT$328.22$559.39
WA$344.95$559.39
WI$343.79$559.39
WV$350.31$559.39
WY$342.07$559.39
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 K0823 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 K0823 with confidence

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