MyMedi-AI

K0853 — Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds

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

Prior authorization

PA REQUIRED K0853 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 K0853 is on Medicare's Required Face-to-Face & WOPD List (Power Mobility Devices — list effective 2026-04-13, 83 items). 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.

K0853 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $1340.51 to $1474.57 depending on state and rural status.

Former-CBA payment limits: ceiling $1340.51 · floor $1139.43

StateNon-ruralRural
AK$1340.51
AL$1340.51
AR$1340.51
AZ$1340.51
CA$1340.51
CO$1340.51
CT$1340.51
DC$1340.51
DE$1340.51
FL$1340.51
GA$1340.51
HI$1340.51
IA$1340.51
ID$1340.51
IL$1340.51
IN$1340.51
KS$1340.51
KY$1340.51
LA$1340.51
MA$1340.51
MD$1340.51
ME$1340.51
MI$1340.51
MN$1340.51
MO$1340.51
MS$1340.51
MT$1340.51
NC$1340.51
ND$1340.51
NE$1340.51
NH$1340.51
NJ$1340.51
NM$1340.51
NV$1340.51
NY$1340.51
OH$1340.51
OK$1340.51
OR$1340.51
PA$1340.51
PR$1474.57
RI$1340.51
SC$1340.51
SD$1340.51
TN$1340.51
TX$1340.51
UT$1340.51
VA$1340.51
VI$1340.51
VT$1340.51
WA$1340.51
WI$1340.51
WV$1340.51
WY$1340.51
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

Bill K0853 with confidence

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