Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDurable medical equipment (DME) Medicare administrative contractors (MACs)HCPCS hcpcs-k0010-standard-weight-frame-power-wheelchair
    Ask Trek AI about this page

    HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

    HCPCS Level II code K0010 describes a standard weight frame motorized/power wheelchair intended to provide mobility for patients requiring a power wheelchair; the service is durable medical equipment (power mobility device) typically provided and delivered in outpatient durable medical equipment settings or home medical equipment supply environments and includes the standard weight frame construction of the powered wheelchair.

    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.

    Customize your policy alerts

    Sign up for hcpcs K0010 policy alerts

    Get alerted when payer policies referencing K0010 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old patient with progressive neuromuscular weakness and limited mobility is evaluated in a durable medical equipment (DME) clinic for mobility aid needs. The referring physician documents that the patient cannot safely and effectively ambulate in the home due to decreased endurance, impaired balance, and risk of falls. A wheelchair assessment by a physical therapist and a mobility specialist confirms that a power-operated mobility device is required to perform activities of daily living and community access. The DME supplier orders a standard, weight-frame motorized/power wheelchair billed with K0010. The workflow includes obtaining a face-to-face physician encounter with documentation of functional limitation, a written order specifying power wheelchair, completion of a detailed mobility evaluation, prior authorization if required by the payer (for example Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare), delivery and in-home setup, patient training, and follow-up to ensure appropriate function and safety.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97542Wheelchair management; fitting and trainingPerformed by occupational or physical therapist to fit the patient to the power wheelchair and provide training prior to delivery
    97530Therapeutic activities, direct one-on-one patient contact (each 15 minutes)Used for functional mobility and transfer training associated with power wheelchair use
    99455Work-related or medical disability evaluation (e.g., DME-related functional capacity)Used when a formal functional capacity evaluation supports need for power wheelchair
    99070Supplies and materials (DME) used during patient careBilled for additional non-implantable items used during fitting or customization when payer allows
    97597Removal of devitalized tissue; more commonly related to wound care but may be used if pressure-relief seating requires wound managementApplied when seating and pressure-relief considerations are part of the overall mobility plan

    Related Modifiers

    7 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…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    251B00000X
    208000000X
    207R00000X
    207RI0001X
    246QC1000X
    2865C1500X
    3104A0630X
    2472B0301X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E11.65Type 2 diabetes mellitus with hyperglycemia
    E11.9Type 2 diabetes mellitus without complications
    F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    G12.21Amyotrophic lateral sclerosis
    G60.9Hereditary and idiopathic neuropathy, unspecified
    G62.9Polyneuropathy, unspecified
    G81.90Hemiplegia, unspecified affecting unspecified side
    G82.20Paraplegia, unspecified
    G82.50Quadriplegia, unspecified
    G83.4Cauda equina syndrome

    Showing 1–10 of 25

    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-K0008-CUSTOM-MANUAL-WHEELCHAIR

    HCPCS K0008: Custom Manual Wheelchair/Base

    HCPCS-K0009-OTHER-MANUAL-WHEELCHAIR-BASE

    HCPCS K0009: Other Manual Wheelchair/Base

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

    HCPCS K0011: Motorized/Power Wheelchair with Programmable Controls

    Showing 1–10 of 135

    • More pages

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.