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K0851 — Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp 3 hd 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)
Status
Active (April 2026 HCPCS)

Prior authorization

PA REQUIRED K0851 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.

K0851 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $1085.92 to $1194.54 depending on state and rural status.

Former-CBA payment limits: ceiling $1085.92 · floor $923.03

StateNon-ruralRural
AK$1085.92
AL$1085.92
AR$1085.92
AZ$1085.92
CA$1085.92
CO$1085.92
CT$1085.92
DC$1085.92
DE$1085.92
FL$1085.92
GA$1085.92
HI$1085.92
IA$1085.92
ID$1085.92
IL$1085.92
IN$1085.92
KS$1085.92
KY$1085.92
LA$1085.92
MA$1085.92
MD$1085.92
ME$1085.92
MI$1085.92
MN$1085.92
MO$1085.92
MS$1085.92
MT$1085.92
NC$1085.92
ND$1085.92
NE$1085.92
NH$1085.92
NJ$1085.92
NM$1085.92
NV$1085.92
NY$1085.92
OH$1085.92
OK$1085.92
OR$1085.92
PA$1085.92
PR$1194.54
RI$1085.92
SC$1085.92
SD$1085.92
TN$1085.92
TX$1085.92
UT$1085.92
VA$1085.92
VI$1085.92
VT$1085.92
WA$1085.92
WI$1085.92
WV$1085.92
WY$1085.92
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

Common denial codes to watch

Related K-codes

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