MyMedi-AI

K0860 — Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp3 vhd sing pow opt s/b” · 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 K0860 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.

K0860 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $1852.46 to $2037.75 depending on state and rural status.

Former-CBA payment limits: ceiling $1852.46 · floor $1574.59

StateNon-ruralRural
AK$1852.46
AL$1852.46
AR$1852.46
AZ$1852.46
CA$1852.46
CO$1852.46
CT$1852.46
DC$1852.46
DE$1852.46
FL$1852.46
GA$1852.46
HI$1852.46
IA$1852.46
ID$1852.46
IL$1852.46
IN$1852.46
KS$1852.46
KY$1852.46
LA$1852.46
MA$1852.46
MD$1852.46
ME$1852.46
MI$1852.46
MN$1852.46
MO$1852.46
MS$1852.46
MT$1852.46
NC$1852.46
ND$1852.46
NE$1852.46
NH$1852.46
NJ$1852.46
NM$1852.46
NV$1852.46
NY$1852.46
OH$1852.46
OK$1852.46
OR$1852.46
PA$1852.46
PR$2037.75
RI$1852.46
SC$1852.46
SD$1852.46
TN$1852.46
TX$1852.46
UT$1852.46
VA$1852.46
VI$1852.46
VT$1852.46
WA$1852.46
WI$1852.46
WV$1852.46
WY$1852.46
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 K0860 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 →