Summary & Overview
HCPCS Level II K0821: Power Wheelchair Group 2 Portable, Captain's Chair
HCPCS Level II code K0821 denotes a group 2 standard portable power wheelchair with a captain's chair and a patient weight capacity up to and including 300 pounds. This code identifies a common category of durable medical equipment used to support mobility for patients with significant functional limitations. Nationally, accurate coding of mobility devices affects coverage determinations, supplier billing, and access to durable medical equipment across payer types.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical and device characteristics, typical sites of service, and payer coverage considerations. The publication outlines where stakeholders typically look for reimbursement and documentation requirements, summarizes common modifiers that may appear on claims, and lists available national benchmarks where data exists.
This resource also provides clinical context about the device class and its role in patient mobility, notes areas where policy updates or coverage criteria commonly apply, and highlights gaps where input was not provided. Data not available in the input is clearly identified. The content serves clinicians, DME suppliers, and billing professionals seeking a national-level briefing on K0821 and what to expect during claims submission and payer review.
Billing Code Overview
HCPCS Level II code K0821 describes a power wheelchair, group 2 standard, portable, captains chair, with patient weight capacity up to and including 300 pounds.
Service type: Durable medical equipment — powered mobility device for mobility assistance.
Typical site of service: Primarily used in the home or community settings, including patient residences and other ambulatory environments where durable medical equipment is supplied and used.
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with progressive Parkinson disease and severe orthostatic hypotension presents to durable medical equipment (DME) services after multiple falls and increasing difficulty with ambulation. He has limited endurance, moderate trunk instability, and requires a seating system with captain's chair configuration for transfers and comfort. The DME clinician performs a mobility assessment in the outpatient clinic, documents medical necessity, weight capacity requirement (patient weight 280 pounds), home accessibility review, and an evaluation of alternative mobility aids. A power wheelchair, group 2 standard, portable, captain's chair with capacity up to and including 300 pounds (billing code K0821) is selected. The ordering physician documents the face-to-face examination, functional limitations, and goals for mobility. The DME supplier delivers the device to the patient’s home, provides fitting and training, records delivery and setup, and bills the payer using K0821 with appropriate modifiers and supplier taxonomy. Typical sites of service include outpatient clinics, the patient’s home, and DME supplier locations. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA plans, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Services not separately payable / no professional component applicable |