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    v1.0.30
    OpenPayerBilling CodesDurable medical equipment (DME) Medicare administrative contractors (MACs)HCPCS hcpcs-k0001-standard-wheelchair-durable-medical-equipment
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    HCPCS K0001: Standard Wheelchair

    HCPCS Level II code K0001 denotes a standard wheelchair — a basic manual wheelchair typically supplied for patients who require mobility assistance; the service is durable medical equipment (DME) provided for use in the home or community and involves delivery, fitting, and patient education as appropriate for wheelchair use.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Bone Growth Stimulators, Prior Authorization for Durable Medical Equipment (DME).

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    Table of contents

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    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
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    Clinical & Coding Specifications

    Clinical Context

    A typical patient receiving a K0001 (Standard wheelchair) is an adult with limited ambulation due to musculoskeletal or neurologic conditions who requires a durable medical equipment (DME) mobility aid for community ambulation and activities of daily living. Example: a 72-year-old patient with advanced osteoarthritis and hip replacement recovery has persistent gait instability and pain that prevents safe household and community mobility. The DME supplier arranges a standard manual wheelchair, documents the patient’s functional limitations, measurements, and home environment assessment, and coordinates delivery and basic user training. The clinical workflow includes clinician evaluation (primary care, physiatry, or orthopedics), documentation of mobility deficit and medical necessity, purchase or rental order to a contracted DME supplier, delivery to the patient’s home, brief seating and safety instruction by the supplier, and follow-up for durability, repairs, or upgrade to a specialized wheelchair if needs change.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97161Physical therapy evaluation, low complexityInitial PT evaluation documenting mobility deficits that support need for a standard wheelchair
    97110Therapeutic exercises to develop strength and enduranceRehabilitation services provided before or after wheelchair provision to improve mobility
    97530Therapeutic activities, direct (one-on-one)Functional training for transfers, wheelchair use, and activities of daily living provided alongside equipment delivery
    99304Initial nursing facility care, new or established patientExample of facility-based evaluation where a wheelchair order for a resident may originate
    99484Care management services, behavioral health integration (short)Care coordination services that may include arranging DME and follow-up logistics

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    208000000X
    261QF0400X
    320600000X
    163WP0000X
    163WX1500X
    163WE0900X
    225CA2500X

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Bone Growth StimulatorsMass General Brigham Health Plan2026-12-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-12-01
    Patient Liftsuniverahealthcare2026-11-16
    Medical Car SeatsCareSource2026-11-01
    Non-Invasive Home Mechanical Ventilation (E0466)CareSource2026-11-01
    Digestive Enzyme Cartridgeshusky_health2026-11-01
    Hearing Aids and Assistive Listening Devices for Children Enrolled in Birth-to-Threehusky_health2026-11-01
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    Related Codes

    HCPCS-K0002-STANDARD-HEMI-LOW-SEAT-WHEELCHAIR

    HCPCS K0002: Standard Hemi (Low Seat) Wheelchair

    HCPCS-K0003-LIGHTWEIGHT-WHEELCHAIR

    HCPCS K0003: Lightweight Wheelchair

    HCPCS-K0004-HIGH-STRENGTH-LIGHTWEIGHT-WHEELCHAIR

    HCPCS K0004: High Strength, Lightweight Wheelchair

    HCPCS-K0005-ULTRALIGHTWEIGHT-WHEELCHAIR

    HCPCS Level II K0005: Ultralightweight Wheelchair

    HCPCS-K0006-HEAVY-DUTY-WHEELCHAIR

    HCPCS Level II K0006: Heavy Duty Wheelchair

    HCPCS-K0007-EXTRA-HEAVY-DUTY-WHEELCHAIR

    HCPCS Level II K0007: Extra Heavy Duty Wheelchair

    HCPCS-K0008-CUSTOM-MANUAL-WHEELCHAIR

    HCPCS K0008: Custom Manual Wheelchair/Base

    HCPCS-K0009-OTHER-MANUAL-WHEELCHAIR-BASE

    HCPCS K0009: Other Manual Wheelchair/Base

    HCPCS-K0010-STANDARD-WEIGHT-FRAME-POWER-WHEELCHAIR

    HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

    HCPCS-K0011-POWER-WHEELCHAIR-PROGRAMMABLE-CONTROLS-TREMOR-DAMPENING

    HCPCS K0011: Motorized/Power Wheelchair with Programmable Controls

    Showing 1–10 of 135

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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