K0195 Elevating Leg Rests HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS K0195: Elevating Leg Rests for Wheelchair Base

HCPCS Level II code K0195 denotes a pair of elevating leg rests intended for use with a capped rental wheelchair base. This code identifies a common durable medical equipment (DME) accessory that supports patient mobility and comfort by allowing leg elevation while seated in a wheelchair. Nationally, correct coding for accessories linked to capped rental equipment matters for claims processing, price transparency, and ensuring patients receive appropriate mobility support.

Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what K0195 represents, the clinical context for use with wheelchairs, and typical sites of service such as outpatient clinics, home settings, and DME suppliers. The analysis covers reimbursement benchmarks where available, payer coverage considerations, and coding nuances relevant to capped rental arrangements.

This publication provides operational clarity for billing teams and administrative staff on using HCPCS Level II code K0195, highlights common payer coverage patterns, and outlines where to look for policy updates affecting capped rental wheelchair accessories. Data not available in the input is indicated where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0195HCPCS Level IIdurable medical equipmentwheelchair accessoryelevating leg restscapped rentalmobility aids

Billing Code Overview

HCPCS Level II code K0195 describes elevating leg rests, pair (for use with capped rental wheelchair base). The service represented by this code is the provision of a pair of elevating leg rests designed to attach to a wheelchair base that is billed as a capped rental item. The service type is durable medical equipment accessory for a mobility device. The typical site of service is outpatient or home use where a capped rental wheelchair base is provided and used by the patient.

Clinical & Coding Specifications

Clinical Context

A patient with limited lower-extremity mobility uses a capped rental wheelchair base and requires a paired set of elevating leg rests to support the lower legs and permit elevation for edema control, pressure relief, or comfort. Typical patients include older adults with chronic venous insufficiency, post‑operative knee or ankle procedures needing temporary elevation, or individuals with spinal cord injury and dependent edema. The clinical workflow begins with a durable medical equipment (DME) evaluation by a prescribing clinician (physician, physiatrist, or nurse practitioner) who documents medical necessity and functional limitations. A DME supplier verifies wheelchair base compatibility with the capped rental base, selects the K0195 elevating leg rests (pair), captures the physician’s order and supporting documentation, and arranges delivery and patient/caregiver education on installation and safe use. Follow-up occurs as clinically indicated to assess fit, pressure points, and need for adjustments or replacement components.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Use when no other modifier applies to the DME shipment.
`52`

HCPCS K0609: Replacement Electrodes for Garment-Type AEDs

HCPCS-K0052-SWINGAWAY-DETACHABLE-FOOTRESTS-REPLACEMENT

HCPCS K0052: Swingaway Detachable Footrests, Replacement Only, Each

HCPCS-K0815-POWER-WHEELCHAIR-GROUP1-SLING-SEAT-UP-TO-300LBS

HCPCS K0815: Power Wheelchair Group 1, Sling/Solid Seat, ≤300 lb

HCPCS-K0669-WHEELCHAIR-SEAT-BACK-CUSHION-UNCLASSIFIED

HCPCS K0669: Wheelchair Seat or Back Cushion, Unclassified

HCPCS-K0825-POWER-WHEELCHAIR-HEAVY-DUTY-301-450-LB-CAPACITY

HCPCS K0825: Power Wheelchair, Group 2 Heavy Duty, 301–450 lb Capacity

HCPCS-K0848-POWER-WHEELCHAIR-GROUP-3-STANDARD-300LB-CAPACITY

HCPCS Level II K0848: Power Wheelchair Group 3, Sling/Solid Seat, 300 lb Capacity

HCPCS-K0859-POWER-WHEELCHAIR-GROUP-3-HEAVY-DUTY-301-450-LB

HCPCS K0859: Power Wheelchair, Group 3 Heavy Duty, 301–450 lb

HCPCS-K0603-REPLACEMENT-ALKALINE-1-5V-BATTERY-INFUSION-PUMP

HCPCS K0603: Replacement Alkaline Battery for Patient-Owned Infusion Pump

HCPCS-K0821-POWER-WHEELCHAIR-GROUP-2-PORTABLE-CAPTAINS-CHAIR-300LB

HCPCS Level II K0821: Power Wheelchair Group 2 Portable, Captain's Chair

HCPCS-K0069-REAR-WHEEL-ASSEMBLY-SOLID-TIRE-REPLACEMENT

HCPCS K0069: Rear Wheel Assembly with Solid Tire, Replacement Only

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Taxonomy Code	Specialty	Notes
`261QA1900X`	Physical Medicine & Rehabilitation	Clinicians who commonly prescribe wheelchair components and leg rests.
`208000000X`	Physical Therapist	Performs seating evaluations and documents functional need for elevating leg rests.
`207Q00000X`	Occupational Therapist	Assesses ADL impact and seating/positioning needs related to leg support.
`207R00000X`	Physician Assistant	May evaluate, prescribe, and follow up on DME placements.
`163W00000X`	Nurse Practitioner	Common prescribing provider for DME in primary and specialty care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I83.10`	Varicose veins of unspecified lower extremity with unspecified complications	Elevation via leg rests reduces dependent venous pooling and symptomatic swelling.
`I87.2`	Venous insufficiency (chronic) (peripheral)	Leg elevation assists edema management and comfort in chronic venous disease.
`M17.11`	Unilateral primary osteoarthritis, right knee	Postural support and leg elevation can be indicated post‑procedure or with pain/effusion.
`M25.561`	Pain in right knee	Helps position and elevate the limb for pain relief and swelling control.
`S83.241A`	Dislocation of right knee, initial encounter	Temporary elevation and support may be used during recovery with a wheelchair.
`G82.50`	Paraplegia, unspecified	Patients with spinal cord injury commonly require wheelchair accessories for positioning and edema prevention.
`R60.0`	Localized edema	Elevating leg rests reduce dependent edema and aid in pressure redistribution.
`Z99.3`	Dependence on wheelchair	Indicates ongoing need for wheelchair accessories such as elevating leg rests.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	Used by therapists during a seating evaluation or training session for transfers and leg rest use.
`97112`	Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception	May be performed in conjunction with fitment and training for elevating leg rests in patients with neuromuscular deficits.
`97755`	Assistive technology assessment, first 30 minutes	Billed for a formal evaluation of mobility devices and wheelchair accessories, including recommendation of elevating leg rests.
`99417`	Prolonged office or other outpatient evaluation and management service beyond the total time of the primary visit	Applicable when additional clinician time is required for complex seating assessments and documentation supporting DME medical necessity.
`A9270`*	Orthotic and prosthetic supply, accessory, and/or component of another orthotic/prosthetic device, not otherwise specified	Used by some payers for miscellaneous wheelchair accessories when specific HCPCS is not billed; relates as an alternative or adjunct classification.

*Note: A9270 is a HCPCS Level II code often referenced in DME workflows; inclusion here is for clinical workflow relevance.

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