K0862 — Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Level II K-code · short descriptor: “Pwc gp3 hd 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 2019-07-22)
- Face-to-face & WOPD
- Required (Power Mobility Devices)
- MUE unit limit
- 1
- Status
- Active (HCPCS Level II October 2026)
Prior authorization
PA REQUIRED K0862 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.
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 K0862 is on Medicare's Required Face-to-Face & WOPD List (Power Mobility Devices — CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). 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.
K0862 Medicare fee schedule (October 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $1296.66 to $1426.39 depending on state and rural status.
Former-CBA payment limits: ceiling $1296.66 · floor $1102.16
| State | Non-rural | Rural |
|---|---|---|
| AK | $1296.66 | — |
| AL | $1296.66 | — |
| AR | $1296.66 | — |
| AZ | $1296.66 | — |
| CA | $1296.66 | — |
| CO | $1296.66 | — |
| CT | $1296.66 | — |
| DC | $1296.66 | — |
| DE | $1296.66 | — |
| FL | $1296.66 | — |
| GA | $1296.66 | — |
| HI | $1296.66 | — |
| IA | $1296.66 | — |
| ID | $1296.66 | — |
| IL | $1296.66 | — |
| IN | $1296.66 | — |
| KS | $1296.66 | — |
| KY | $1296.66 | — |
| LA | $1296.66 | — |
| MA | $1296.66 | — |
| MD | $1296.66 | — |
| ME | $1296.66 | — |
| MI | $1296.66 | — |
| MN | $1296.66 | — |
| MO | $1296.66 | — |
| MS | $1296.66 | — |
| MT | $1296.66 | — |
| NC | $1296.66 | — |
| ND | $1296.66 | — |
| NE | $1296.66 | — |
| NH | $1296.66 | — |
| NJ | $1296.66 | — |
| NM | $1296.66 | — |
| NV | $1296.66 | — |
| NY | $1296.66 | — |
| OH | $1296.66 | — |
| OK | $1296.66 | — |
| OR | $1296.66 | — |
| PA | $1296.66 | — |
| PR | $1426.39 | — |
| RI | $1296.66 | — |
| SC | $1296.66 | — |
| SD | $1296.66 | — |
| TN | $1296.66 | — |
| TX | $1296.66 | — |
| UT | $1296.66 | — |
| VA | $1296.66 | — |
| VI | $1296.66 | — |
| VT | $1296.66 | — |
| WA | $1296.66 | — |
| WI | $1296.66 | — |
| WV | $1296.66 | — |
| WY | $1296.66 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0862 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.
Common denial codes to watch
Related K-codes
Bill K0862 with confidence
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