Summary & Overview
HCPCS K0823: Power Wheelchair Group 2, Captain's Chair (≤300 lb)
HCPCS Level II code K0823 designates a group 2 standard power wheelchair with a captain's chair and a patient weight capacity up to and including 300 pounds. This equipment code matters nationally because powered mobility devices are essential for independent living, impact durable medical equipment (DME) benefit management, and intersect clinical, functional and coverage policy decisions across public and commercial payers. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find an overview of what the code represents, payer coverage considerations, and the clinical context for power wheelchair selection. The publication summarizes typical sites of service and service type, highlights benchmarks and common modifiers where available, and outlines policy and reimbursement themes affecting access to powered mobility. It also provides practical reference material for billing and claims teams, procurement specialists, and clinical managers responsible for mobility device ordering and authorization. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code K0823 describes a power wheelchair, group 2 standard, captain's chair, with a patient weight capacity up to and including 300 pounds. The service type is durable medical equipment for mobility assistance, intended to provide powered mobility for patients with mobility impairments. The typical site of service is outpatient or home use, where the device is supplied for daily mobility needs.
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Clinical & Coding Specifications
Clinical Context
A 72-year-old male with progressive mobility impairment due to advanced Parkinson disease and post-stroke hemiparesis presents to durable medical equipment (DME) services for evaluation. He has difficulty ambulating safely in the community, recurrent falls, and requires a seated mobility device for activities of daily living. A clinician (physiatrist or occupational therapist) completes a mobility assessment, documents medical necessity for a power wheelchair with a captain's chair and a patient weight capacity up to and including 300 pounds, and prescribes a Group 2 standard power wheelchair, billed as K0823. The DME supplier verifies payer coverage, obtains prior authorization when required, performs a home assessment for safe access and maneuverability, orders the equipment, schedules delivery and patient training, and documents device functionality and patient education in the medical record. Typical sites of service include outpatient DME vendors, patient homes for delivery and training, and hospital outpatient clinics for initial evaluation and ordering.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; only when no specific modifier applies and payer allows |
22 |