2025 HCPCS code K0823
(Active) Effective Date: N/A Revision Date: N/A Durable Medical Equipment - Power Wheelchairs Durable Medical Equipment (DME) Feed
Supply of a group 2 power wheelchair with a captain's chair, standard weight capacity up to 300 pounds.
Modifiers may apply depending on circumstances.Refer to HCPCS guidelines for specific modifier applications.
The power wheelchair must be deemed medically necessary to improve the patient's mobility and independence in performing activities of daily living.The patient must have a condition that prevents the use of alternative assistive devices such as canes, walkers, or manual wheelchairs.Prior authorization may be required by some payers.
The supplying provider is responsible for conducting a face-to-face patient encounter to assess the medical necessity of the power wheelchair.Documentation must clearly indicate the patient's condition and why a power wheelchair is necessary.The provider must also ensure the patient can safely operate the wheelchair independently.
In simple words: This code is for providing a motorized wheelchair with extra support (captain's chair) for people who can't walk or use a regular wheelchair because of limited arm strength or other physical limitations. The doctor must meet with the patient to decide if it's needed, and it must be medically necessary.
This HCPCS code, K0823, covers the supply of a group 2 power wheelchair featuring a captain's chair and a standard weight capacity of up to 300 pounds.It is indicated for patients with impaired ability to perform activities of daily living, inability to ambulate, and insufficient upper extremity strength to utilize a manual wheelchair.The supplying provider must document a face-to-face encounter with the patient and clearly state the medical necessity for the power wheelchair. Medicare coverage requires documentation of medical necessity.
Example 1: A 70-year-old patient with severe osteoarthritis and limited mobility is unable to use a manual wheelchair due to weakness.A K0823 power wheelchair is prescribed to enhance their independence., A patient recovering from a stroke exhibits significant upper extremity weakness and is unable to self-propel a manual wheelchair.A K0823 power wheelchair improves their mobility and participation in rehabilitation., A patient with muscular dystrophy experiences progressive muscle weakness, making it impossible to ambulate or use a manual wheelchair.A K0823 power wheelchair is medically necessary to maintain their quality of life.
* Documentation of a face-to-face encounter with the patient.* Detailed clinical justification for the medical necessity of a power wheelchair.* Assessment of the patient's ability to safely operate the wheelchair.* Confirmation of the patient's weight to ensure compatibility with the wheelchair's weight capacity.
** This code is part of a larger range of power wheelchair codes.Always refer to the complete HCPCS code set for the most up-to-date information and to ensure proper selection based on patient-specific characteristics and wheelchair specifications.
- Payment Status: Active
- Specialties:Physical Medicine and Rehabilitation, Occupational Therapy
- Place of Service:Office, Home, Inpatient Hospital, Outpatient Hospital