MyMedi-AI

K0854 — Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more

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

Prior authorization

PA REQUIRED K0854 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.

K0854 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $1775.89 to $1953.49 depending on state and rural status.

Former-CBA payment limits: ceiling $1775.89 · floor $1509.51

StateNon-ruralRural
AK$1775.89—
AL$1775.89—
AR$1775.89—
AZ$1775.89—
CA$1775.89—
CO$1775.89—
CT$1775.89—
DC$1775.89—
DE$1775.89—
FL$1775.89—
GA$1775.89—
HI$1775.89—
IA$1775.89—
ID$1775.89—
IL$1775.89—
IN$1775.89—
KS$1775.89—
KY$1775.89—
LA$1775.89—
MA$1775.89—
MD$1775.89—
ME$1775.89—
MI$1775.89—
MN$1775.89—
MO$1775.89—
MS$1775.89—
MT$1775.89—
NC$1775.89—
ND$1775.89—
NE$1775.89—
NH$1775.89—
NJ$1775.89—
NM$1775.89—
NV$1775.89—
NY$1775.89—
OH$1775.89—
OK$1775.89—
OR$1775.89—
PA$1775.89—
PR$1953.49—
RI$1775.89—
SC$1775.89—
SD$1775.89—
TN$1775.89—
TX$1775.89—
UT$1775.89—
VA$1775.89—
VI$1775.89—
VT$1775.89—
WA$1775.89—
WI$1775.89—
WV$1775.89—
WY$1775.89—
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

CO-50 medical necessityCO-197 no prior auth

Related K-codes

K0800K0801K0802K0806K0807K0808K0812K0813K0814K0815K0816K0820

Bill K0854 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →