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    v1.0.30
    OpenPayerBilling CodesDurable medical equipment (DME) Medicare administrative contractors (MACs)HCPCS hcpcs-k0011-power-wheelchair-programmable-controls-tremor-dampening
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    HCPCS K0011: Motorized/Power Wheelchair with Programmable Controls

    HCPCS Level II code K0011 describes a standard weight-frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking and is billed for durable medical equipment motorized wheelchair provision; service type: power/motorized wheelchair supply and setup; typical site of service: durable medical equipment supplier, outpatient clinic, patient home for home use and mobility support.

    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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    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
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    Clinical & Coding Specifications

    Clinical Context

    An adult patient with progressive mobility impairment from neurologic or musculoskeletal disease is evaluated for a powered wheelchair. The typical candidate has limited walking tolerance, unsafe ambulation, or energy-conserving needs due to diagnoses such as advanced Parkinson disease, multiple sclerosis, stroke with residual hemiparesis, severe osteoarthritis, or spinal cord injury. A multidisciplinary outpatient or home-based durable medical equipment (DME) assessment is performed by a physician and a DME specialist or occupational therapist to document functional mobility deficits, seating and positioning needs, and the need for programmable control features (speed adjustment, tremor dampening, acceleration control and braking).

    The clinical workflow begins with the referring clinician documenting medical necessity and ICD-10 diagnosis codes in the medical record. A DME supplier conducts a face-to-face assessment (often in clinic or the patient’s home), measures for fit, reviews power seating and control options, and verifies that standard weight-frame power wheelchair features meet the patient’s needs. For Medicare and commercial payors, supporting documentation includes objective mobility tests (6-minute walk, timed up-and-go if available), notes on safety concerns, home environment accessibility, and prior use of assistive devices. After authorization, the supplier programs the wheelchair’s control parameters and provides training, delivery, and follow-up adjustments in the typical site of service (outpatient DME clinic, specialty rehabilitation clinic, or patient’s home).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92507Treatment of speech, language, voice, communication, and/or auditory processing disorders; each 15 minutesOccasionally billed when communication device adjustments occur during wheelchair training sessions (rare adjunct)
    97161Physical therapy evaluation, low complexityPerformed prior to DME ordering to document mobility deficits and support medical necessity
    97110Therapeutic exercises to develop strength and endurance, range of motion and flexibilityUsed during pre-provision therapy to improve function or during training for wheelchair use
    97530Therapeutic activities, direct (one-on-one) patient contactUsed for functional mobility training, transfers, and powered wheelchair driving practice
    97750Physical performance test or measurement (e.g., timed walk)Objective testing to document mobility limitations and need for power mobility

    Related Modifiers

    8 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…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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
    207R00000X
    208U00000X
    2082S0099X
    207QH0002X
    364SP0807X
    2278P3800X
    172P00000X
    261QM0855X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    E10.9Type 1 diabetes mellitus without complications
    E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
    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
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    G12.21Amyotrophic lateral sclerosis
    G25.0Essential tremor
    G25.3Myoclonus
    G31.84Mild cognitive impairment of uncertain or unknown etiology
    G82.20Paraplegia, unspecified

    Showing 1–10 of 27

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

    HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

    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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