K0861 — Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp3 std mult 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 2017-07-17)
Status: Active (April 2026 HCPCS)

Prior authorization

PA REQUIRED K0861 is on Medicare's DMEPOS Required Prior Authorization List (Power Mobility Devices — nationwide since 2017-07-17).

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.

K0861 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $1046.78 to $1151.47 depending on state and rural status.

Former-CBA payment limits: ceiling $1046.78 · floor $889.76

State	Non-rural	Rural
AK	$1046.78	—
AL	$1046.78	—
AR	$1046.78	—
AZ	$1046.78	—
CA	$1046.78	—
CO	$1046.78	—
CT	$1046.78	—
DC	$1046.78	—
DE	$1046.78	—
FL	$1046.78	—
GA	$1046.78	—
HI	$1046.78	—
IA	$1046.78	—
ID	$1046.78	—
IL	$1046.78	—
IN	$1046.78	—
KS	$1046.78	—
KY	$1046.78	—
LA	$1046.78	—
MA	$1046.78	—
MD	$1046.78	—
ME	$1046.78	—
MI	$1046.78	—
MN	$1046.78	—
MO	$1046.78	—
MS	$1046.78	—
MT	$1046.78	—
NC	$1046.78	—
ND	$1046.78	—
NE	$1046.78	—
NH	$1046.78	—
NJ	$1046.78	—
NM	$1046.78	—
NV	$1046.78	—
NY	$1046.78	—
OH	$1046.78	—
OK	$1046.78	—
OR	$1046.78	—
PA	$1046.78	—
PR	$1151.47	—
RI	$1046.78	—
SC	$1046.78	—
SD	$1046.78	—
TN	$1046.78	—
TX	$1046.78	—
UT	$1046.78	—
VA	$1046.78	—
VI	$1046.78	—
VT	$1046.78	—
WA	$1046.78	—
WI	$1046.78	—
WV	$1046.78	—
WY	$1046.78	—

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 necessity CO-197 no prior auth

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