Key facts for K0806
- Medicare payment
- $1,748.83
- DMEPOS non-rural state fees (NU)
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- DME supplier MUE
- 1
- MAI 2
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 1 / 0
TL;DR
K0806 is a Level II code from the K section (temporary codes for DME Medicare administrative contractors), in use since 2006: "Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds". K0806 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $1,748.83 in every contiguous state, rural $1,834.90; RR (rental) $174.88 in every contiguous state, rural $183.49; UE (purchased, used) $1,311.63 in every contiguous state, rural $1,376.19, October 2026. MUE limits for K0806: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction). 1 active LCD lists K0806: L33789 (Power Mobility Devices). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1D (wheelchairs); pricing indicator 32; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). 6 other active codes open with "Power operated vehicle"; related codes: K0800, K0807, K0808, K0802.
K0806 descriptor and code status
The October 2026 HCPCS Level II file describes K0806 as “Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds”. It sits in the K section (temporary codes for DME Medicare administrative contractors), listed with the other K codes.
| Field | Value |
|---|---|
| Short descriptor | Pov group 2 std up to 300lbs |
| Added to HCPCS | 2006-10-01 |
| Last action | N (no maintenance), effective 2006-10-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 32: DMEPOS inexpensive and routinely purchased DME (floors and ceilings) |
| BETOS category | D1D: wheelchairs |
| Type of service | A: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME |
Medicare payment for K0806
K0806 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $1,748.83 in every contiguous state, rural $1,834.90; RR (rental) $174.88 in every contiguous state, rural $183.49; UE (purchased, used) $1,311.63 in every contiguous state, rural $1,376.19, October 2026. 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 IN (inexpensive and other routinely purchased 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.
| Modifier | Floor / ceiling | Non-rural state range | Rural range | AK / HI / PR / VI |
|---|---|---|---|---|
| NU (purchased, new) | — | $1,748.83 (49 states) | $1,834.90 (49 states) | AK $1,834.90, HI $1,834.90, PR $1,930.97, VI $1,834.90 |
| RR (rental) | — | $174.88 (49 states) | $183.49 (49 states) | AK $183.49, HI $183.49, PR $193.09, VI $183.49 |
| UE (purchased, used) | — | $1,311.63 (49 states) | $1,376.19 (49 states) | AK $1,376.19, HI $1,376.19, PR $1,448.24, VI $1,376.19 |
Hospital outpatient (OPPS Addendum B)
Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.
Medically Unlikely Edits for K0806
MUE limits for K0806: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction). The DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
| Facility outpatient hospital | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
| DME supplier | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
The MUE lookup for K0806 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists K0806 in v323r0.
K0806 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 K0806 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for K0806
1 active Local Coverage Determination and 0 billing and coding articles list K0806. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Power Mobility Devices, LCD L33789 · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
Denials to expect on K0806
the diagnosis or documentation does not meet the LCD or billing article that lists K0806
the NU, RR, UE payment modifier is missing or does not match the item
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for K0806 claims
QuickAuth coordinates the requirement checks and documentation that DME claims for K0806 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.
Frequently asked questions: HCPCS K0806
What does HCPCS code K0806 describe?
"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds" (short descriptor "Pov group 2 std up to 300lbs"), in the K section (temporary codes for DME Medicare administrative contractors). Added 2006-10-01.
Is K0806 a CPT code?
No: CMS maintains K0806 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.
What does Medicare pay for K0806?
K0806 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $1,748.83 in every contiguous state, rural $1,834.90; RR (rental) $174.88 in every contiguous state, rural $183.49; UE (purchased, used) $1,311.63 in every contiguous state, rural $1,376.19, October 2026.
How many units of K0806 can be billed per day?
MUE limits for K0806: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction). For the DME supplier MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.
Does Medicare cover K0806?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists K0806: L33789 (Power Mobility Devices).
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- DMEPOS fee schedule DME26-D, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file DMEPOS_OCT.csvSHA-256 a2824d58aadf4004…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
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.