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HCPCS K0011 · Level II · K code

K0011: Stnd wt pwr whlchr w control, HCPCS Level II K code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update).

Key facts for K0011

Medicare payment
$641.58 to $730.07
DMEPOS non-rural state fees (RR)
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
0
MAI 3
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

K0011 is a Level II code from the K section (temporary codes for DME Medicare administrative contractors), in use since 1994: "Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking". The October 2026 DMEPOS fee schedule (category CR, capped rental items) sets K0011 at RR (rental) $641.58 in RI to $730.07 in AR, CO, CT and 22 more; RR-KF (rental) $712.33 in RI to $810.55 in NY. CMS caps K0011 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, Published Contractor Policy) units per day in the 2026 Q4 MUE tables. K0011 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD. OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1D (wheelchairs); pricing indicator 36; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). Nearby codes: K0007, K0005, K0003, K0002.

K0011 descriptor and code status

The October 2026 HCPCS Level II file describes K0011 as “Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking”. It sits in the K section (temporary codes for DME Medicare administrative contractors), listed with the other K codes.

HCPCS file attributes of K0011
FieldValue
Short descriptorStnd wt pwr whlchr w control
Added to HCPCS1994-01-01
Last actionN (no maintenance), effective 1997-05-05
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator36: DMEPOS capped rental DME (floors and ceilings)
BETOS categoryD1D: wheelchairs
Type of serviceA: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME

Medicare payment for K0011

The October 2026 DMEPOS fee schedule (category CR, capped rental items) sets K0011 at RR (rental) $641.58 in RI to $730.07 in AR, CO, CT and 22 more; RR-KF (rental) $712.33 in RI to $810.55 in NY. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category CR (capped rental items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for K0011 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
RR (rental)—$641.58 (RI) to $730.07 (AR, CO, CT…)—AK $730.01, HI $730.07, PR $730.07, VI $730.07
RR (rental), KF (FDA class III device)—$712.33 (RI) to $810.55 (NY)—AK $810.49, HI $810.57, PR $810.53, VI $810.53

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for K0011

CMS caps K0011 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, Published Contractor Policy) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for K0011 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier03 Date of Service Edit: ClinicalPublished Contractor Policy

The MUE lookup for K0011 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists K0011 in v323r0.

K0011 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check K0011 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for K0011

No current LCD or billing and coding article lists K0011. The HCPCS coverage code C means carrier judgment, so the Medicare contractor decides coverage, and any National Coverage Determination for the service still applies.

Denials to expect on K0011

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of K0011 exceed the DME supplier MUE of 0 per date of service

CARC 4

the RR, KF payment modifier is missing or does not match the item

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for K0011 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for K0011 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS K0011

What does HCPCS code K0011 describe?

"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking" (short descriptor "Stnd wt pwr whlchr w control"), in the K section (temporary codes for DME Medicare administrative contractors). Added 1994-01-01; last action N (no maintenance) effective 1997-05-05.

Is K0011 a CPT code?

It is not. K0011 belongs to the K section (temporary codes for DME Medicare administrative contractors) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for K0011?

The October 2026 DMEPOS fee schedule (category CR, capped rental items) sets K0011 at RR (rental) $641.58 in RI to $730.07 in AR, CO, CT and 22 more; RR-KF (rental) $712.33 in RI to $810.55 in NY.

How many units of K0011 can be billed per day?

CMS caps K0011 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, Published Contractor Policy) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover K0011?

K0011 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.