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    v1.0.30
    OpenPayerBilling CodesDurable medical equipment (DME) Medicare administrative contractors (MACs)HCPCS hcpcs-k0008-custom-manual-wheelchair
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    HCPCS K0008: Custom Manual Wheelchair/Base

    HCPCS Level II code K0008 describes a custom manual wheelchair/base designed and fabricated to meet unique patient needs; the service represents provision of a customized mobility device tailored to individual anthropometrics and functional requirements, typically delivered as durable medical equipment (DME) and dispensed in outpatient DME suppliers, rehabilitation clinics, or specialized mobility centers.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Patient Lifts, Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with progressive spastic paraplegia and significant postural instability is evaluated in a durable medical equipment clinic for mobility needs. The patient has failed to achieve safe, independent mobility with standard, off-the-shelf wheelchairs due to abnormal tone, fixed spinal deformity, and unique seat-to-floor height requirements. An orthotist and a rehabilitation physician collaborate to prescribe a K0008 custom manual wheelchair/base with individualized seating, frame modifications, and accessory mounting points.

    The clinical workflow includes a comprehensive mobility assessment (history, functional mobility testing, transfers, posture and skin assessment), seating and positioning evaluation, measurement for custom fabrication, physician prescription with clinical justification, and fitting/training once the custom base is delivered. Documentation includes objective functional deficits, prior mobility devices tried, specific custom features required (e.g., modified axle position, reinforced frame, custom seat dimensions), measurable goals for mobility and activities of daily living, and the supplier’s itemized fabrication details. Follow-up visits assess fit, skin integrity, and function, with adjustments authorized as needed.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97162Physical therapy evaluation, moderate complexityPerformed by therapist to assess mobility needs and justify custom seating prescription prior to ordering K0008
    97760Orthotic management and training, initial encounterUsed when training patient in use, donning/doffing, transfers, and safe mobility with the custom wheelchair/base
    92507Treatment of speech, language, voice, swallowing; not directly relatedData not applicable to wheelchair provision; included only if interdisciplinary rehab required
    99456Work-related medical evaluation (e.g., return-to-work)Used when wheelchair provision is part of a worker’s compensation evaluation and reporting
    99354Prolonged service in the outpatient setting, face-to-faceMay apply when extended clinician time is necessary for complex seating evaluation and documentation

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…
    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…
    P3Modifier P3 denotes that the anesthesia patient has severe systemic disease (ASA III). It applies only to anesthesia CPT codes (00100–01999) and must be appended by the anesthesia provider with…- Applies only to anesthesia procedure codes (CPT 00100–01999) and should be appended by the anesthesia provider when the patient meets the definition of "severe systemic disease" (CPT/AAPC P3;…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    333600000X
    273100000X
    364SC2300X
    207QB0002X
    242T00000X
    363LP0200X
    2085R0203X
    207ZP0007X

    Related ICD-10-CM Codes

    19 rows

    ICD-10-CM CodeDescription
    E11.9Type 2 diabetes mellitus without complications
    G12.21Amyotrophic lateral sclerosis
    G82.20Paraplegia, unspecified
    G82.21Paraplegia, complete
    G82.50Quadriplegia, unspecified
    G82.51Quadriplegia, C1-C4 complete
    G83.4Cauda equina syndrome
    I69.391Dysphagia following cerebral infarction
    M15.0Primary generalized (osteo)arthritis
    M16.11Unilateral primary osteoarthritis, right hip

    Showing 1–10 of 19

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Patient Liftsuniverahealthcare2026-11-16
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Positive Airway Pressure Devices for Pulmonary Disorders Continued RentalCareSource Georgia2026-10-01
    Bone Growth StimulatorsProvidence Health Plan2026-10-01
    Durable Medical Equipment (DME) Medical Necessity and CoverageMass General Brigham Health Plan2026-10-01
    Speech Generating DevicesMass General Brigham Health Plan2026-10-01
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-K0001-STANDARD-WHEELCHAIR-DURABLE-MEDICAL-EQUIPMENT

    HCPCS K0001: Standard Wheelchair

    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-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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