K0859 — Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
HCPCS Level II K-code · short descriptor: “Pwc gp3 hd sing pow opt cap” · 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 2019-07-22)
- Status
- Active (April 2026 HCPCS)
Prior authorization
PA REQUIRED K0859 is on Medicare's DMEPOS Required Prior Authorization List (Power Mobility Devices — nationwide since 2019-07-22).
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.
K0859 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $1236.63 to $1360.29 depending on state and rural status.
Former-CBA payment limits: ceiling $1236.63 · floor $1051.14
| State | Non-rural | Rural |
|---|---|---|
| AK | $1236.63 | — |
| AL | $1236.63 | — |
| AR | $1236.63 | — |
| AZ | $1236.63 | — |
| CA | $1236.63 | — |
| CO | $1236.63 | — |
| CT | $1236.63 | — |
| DC | $1236.63 | — |
| DE | $1236.63 | — |
| FL | $1236.63 | — |
| GA | $1236.63 | — |
| HI | $1236.63 | — |
| IA | $1236.63 | — |
| ID | $1236.63 | — |
| IL | $1236.63 | — |
| IN | $1236.63 | — |
| KS | $1236.63 | — |
| KY | $1236.63 | — |
| LA | $1236.63 | — |
| MA | $1236.63 | — |
| MD | $1236.63 | — |
| ME | $1236.63 | — |
| MI | $1236.63 | — |
| MN | $1236.63 | — |
| MO | $1236.63 | — |
| MS | $1236.63 | — |
| MT | $1236.63 | — |
| NC | $1236.63 | — |
| ND | $1236.63 | — |
| NE | $1236.63 | — |
| NH | $1236.63 | — |
| NJ | $1236.63 | — |
| NM | $1236.63 | — |
| NV | $1236.63 | — |
| NY | $1236.63 | — |
| OH | $1236.63 | — |
| OK | $1236.63 | — |
| OR | $1236.63 | — |
| PA | $1236.63 | — |
| PR | $1360.29 | — |
| RI | $1236.63 | — |
| SC | $1236.63 | — |
| SD | $1236.63 | — |
| TN | $1236.63 | — |
| TX | $1236.63 | — |
| UT | $1236.63 | — |
| VA | $1236.63 | — |
| VI | $1236.63 | — |
| VT | $1236.63 | — |
| WA | $1236.63 | — |
| WI | $1236.63 | — |
| WV | $1236.63 | — |
| WY | $1236.63 | — |
Common denial codes to watch
Related K-codes
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