MyMedi-AI

K0826 — Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp 2 vhd 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 K0826 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 K0826 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.

K0826 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $799.42 to $1211.30 depending on state and rural status.

StateNon-ruralRural
AK$1153.54—
AL$912.92$1069.98
AR$912.92$1069.98
AZ$856.69$1069.98
CA$906.27$1069.98
CO$916.00$1069.98
CT$835.83$1069.98
DC$799.42$1069.98
DE$799.42$1069.98
FL$912.92$1069.98
GA$912.92$1069.98
HI$1153.54—
IA$954.05$1069.98
ID$916.00$1069.98
IL$958.44$1069.98
IN$958.44$1069.98
KS$954.05$1069.98
KY$912.92$1069.98
LA$912.92$1069.98
MA$835.83$1069.98
MD$799.42$1069.98
ME$835.83$1069.98
MI$958.44$1069.98
MN$954.05$1069.98
MO$954.05$1069.98
MS$912.92$1069.98
MT$916.00$1069.98
NC$912.92$1069.98
ND$954.05$1069.98
NE$954.05$1069.98
NH$835.83$1069.98
NJ$799.42$1069.98
NM$856.69$1069.98
NV$906.27$1069.98
NY$799.42$1069.98
OH$958.44$1069.98
OK$856.69$1069.98
OR$906.27$1069.98
PA$799.42$1069.98
PR$1211.30—
RI$835.83$1069.98
SC$912.92$1069.98
SD$954.05$1069.98
TN$912.92$1069.98
TX$856.69$1069.98
UT$916.00$1069.98
VA$912.92$1069.98
VI$1153.54—
VT$835.83$1069.98
WA$906.27$1069.98
WI$958.44$1069.98
WV$912.92$1069.98
WY$916.00$1069.98
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 K0826 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 K0826 with confidence

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