Find policies, billing codes, payers, states, and providers

HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

HCPCS Level II code K0010 denotes a standard-weight frame motorized/power wheelchair, a common durable medical equipment (DME) item that enables mobility and functional independence for individuals with mobility limitations. Nationally, powered wheelchairs are important for long-term mobility support, reducing caregiver burden and enabling community participation, and they have implications for benefit design, prior authorization, and durable medical equipment supply chains.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations and typical clinical contexts for use, as well as benchmarking elements such as utilization and reimbursement patterns where available. The publication also outlines common documentation and medical necessity themes relevant to powered wheelchair claims and highlights policy and coding updates that affect billing for motorized wheelchair equipment.

The content is aimed at billing professionals, DME suppliers, and policy analysts seeking a concise reference for HCPCS Level II code K0010, offering operational context and a national perspective on payer coverage, documentation expectations, and areas to monitor for policy change. Data not available in the input is explicitly noted where applicable.

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.

Billing Code Overview

HCPCS Level II code K0010 describes a standard weight frame motorized/power wheelchair. This item represents a powered mobility device built on a standard-weight frame designed to provide seated mobility for individuals with mobility impairments.

Service type: Durable medical equipment (power wheelchair)
Typical site of service: Durable medical equipment is typically used in the patient's home or other community settings where mobility assistance is required.

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

Find policies, billing codes, payers, states, and providers

HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

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.

Billing Code Overview

Service type: Durable medical equipment (power wheelchair)
Typical site of service: Durable medical equipment is typically used in the patient's home or other community settings where mobility assistance is required.

Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.

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.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier / default	Use when no special circumstance applies to the claim
`22`	Increased procedural services	Use when significantly greater effort or complexity was documented for fitting or customization beyond standard delivery
`52`	Reduced services	Use when a service was partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when delivery or setup was discontinued for documented clinical reasons
`62`	Two surgeons / providers	Use when two qualified providers share responsibility for evaluation or complex customization tasks
`78`	Unplanned return to the operating/procedure area	Rare for DME; use if the patient required unplanned return for device-related procedure or major service within global period
`80`	Assistant at service	Use when an assistant (e.g., certified technician) is documented as participating in setup or customization and payer requires reporting
`82`	Assistant not available / reduced services	Use when an assistant was used but services differ from usual assistant services
`RR`	Recovery room services	Use only if billable recovery-related services were provided in conjunction with device-related procedure
`UE`	Upper extremity prosthetic/orthotic modifier	Use when the mobility device interfaces with upper-extremity prosthetic components (rare)
`QK`	Medical direction of two, three, or four ancillary personnel	Use when medical direction is documented for supervised ancillary personnel during complex fitting
`QX`	Auxiliary personnel with qualified professional supervision	Use when auxiliary personnel perform services under supervision for which reporting is appropriate
`QY`	Attending physician of record (resuscitative services)	Use only when applicable per payer rules for physician oversight

Taxonomy Code	Specialty	Notes
251B00000X	Physical Therapist	Performs mobility evaluations and documents functional limitations and seating needs
3336P0800X	Durable Medical Equipment Supplier	Orders, supplies, fits, and trains patient on power wheelchair delivery
208000000X	Physical Medicine & Rehabilitation Physician	Provides face-to-face evaluation, certifies medical necessity, and manages complex functional needs
261QM0800X	Occupational Therapist	Evaluates activities of daily living and recommends positioning, controls, and adaptations
207R00000X	Family Medicine Physician	Common certifying provider in primary care settings for DME orders

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G82.50`	Paraplegia, unspecified	Motorized wheelchair indicated when lower extremity paralysis prevents independent ambulation
`G12.21`	Amyotrophic lateral sclerosis	Progressive neuromuscular decline often necessitates power mobility for safety and ADLs
`G35`	Multiple sclerosis	Variable disability with fatigue and balance impairment where power wheelchair improves participation
`M62.81`	Muscle weakness (generalized)	Significant weakness limiting household and community ambulation supports power wheelchair need
`R26.2`	Difficulty in walking, not elsewhere classified	Functional gait impairment where a powered mobility device restores safety and independence

Related CPT Codes

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

HCPCS Level II 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 K0005: Ultralightweight Wheelchair

HCPCS-K0006-HEAVY-DUTY-WHEELCHAIR

HCPCS Level II K0006: Heavy Duty Wheelchair

HCPCS-K0007-EXTRA-HEAVY-DUTY-WHEELCHAIR

HCPCS K0007: Extra Heavy Duty Wheelchair

HCPCS-K0008-CUSTOM-MANUAL-WHEELCHAIR

HCPCS Level II 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: Power Wheelchair with Programmable Controls

Showing 1–10 of 135

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier / default	Use when no special circumstance applies to the claim
`22`	Increased procedural services	Use when significantly greater effort or complexity was documented for fitting or customization beyond standard delivery
`52`	Reduced services	Use when a service was partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when delivery or setup was discontinued for documented clinical reasons
`62`	Two surgeons / providers	Use when two qualified providers share responsibility for evaluation or complex customization tasks
`78`	Unplanned return to the operating/procedure area	Rare for DME; use if the patient required unplanned return for device-related procedure or major service within global period
`80`	Assistant at service	Use when an assistant (e.g., certified technician) is documented as participating in setup or customization and payer requires reporting
`82`	Assistant not available / reduced services	Use when an assistant was used but services differ from usual assistant services
`RR`	Recovery room services	Use only if billable recovery-related services were provided in conjunction with device-related procedure
`UE`	Upper extremity prosthetic/orthotic modifier	Use when the mobility device interfaces with upper-extremity prosthetic components (rare)
`QK`	Medical direction of two, three, or four ancillary personnel	Use when medical direction is documented for supervised ancillary personnel during complex fitting
`QX`	Auxiliary personnel with qualified professional supervision	Use when auxiliary personnel perform services under supervision for which reporting is appropriate
`QY`	Attending physician of record (resuscitative services)	Use only when applicable per payer rules for physician oversight

Taxonomy Code	Specialty	Notes
251B00000X	Physical Therapist	Performs mobility evaluations and documents functional limitations and seating needs
3336P0800X	Durable Medical Equipment Supplier	Orders, supplies, fits, and trains patient on power wheelchair delivery
208000000X	Physical Medicine & Rehabilitation Physician	Provides face-to-face evaluation, certifies medical necessity, and manages complex functional needs
261QM0800X	Occupational Therapist	Evaluates activities of daily living and recommends positioning, controls, and adaptations
207R00000X	Family Medicine Physician	Common certifying provider in primary care settings for DME orders

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G82.50`	Paraplegia, unspecified	Motorized wheelchair indicated when lower extremity paralysis prevents independent ambulation
`G12.21`	Amyotrophic lateral sclerosis	Progressive neuromuscular decline often necessitates power mobility for safety and ADLs
`G35`	Multiple sclerosis	Variable disability with fatigue and balance impairment where power wheelchair improves participation
`M62.81`	Muscle weakness (generalized)	Significant weakness limiting household and community ambulation supports power wheelchair need
`R26.2`	Difficulty in walking, not elsewhere classified	Functional gait impairment where a powered mobility device restores safety and independence

Related CPT Codes

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

HCPCS Level II 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 K0005: Ultralightweight Wheelchair

HCPCS-K0006-HEAVY-DUTY-WHEELCHAIR

HCPCS Level II K0006: Heavy Duty Wheelchair

HCPCS-K0007-EXTRA-HEAVY-DUTY-WHEELCHAIR

HCPCS K0007: Extra Heavy Duty Wheelchair

HCPCS-K0008-CUSTOM-MANUAL-WHEELCHAIR

HCPCS Level II 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: Power Wheelchair with Programmable Controls

Showing 1–10 of 135

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

OpenPayer

HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

Sign up for hcpcs K0010 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

Sign up for hcpcs K0010 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References