K0835 Power Wheelchair (HCPCS) Reimbursement

HCPCS Level II code K0835 designates a group 2 standard power wheelchair with a single power option and a sling/solid seat/back, rated for patients weighing up to and including 300 pounds. As a frequently used durable medical equipment (DME) code, K0835 matters nationally because it corresponds to essential mobility technology for individuals with significant functional limitations and influences coverage, access, and supply chain decisions across payers and care settings. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn what K0835 represents clinically and operationally, which settings commonly supply and use this device (home and non-acute care environments), and what national stakeholders often consider when reviewing DME power mobility claims. The publication provides benchmarks and policy context where available, outlines common billing and documentation considerations tied to DME coverage policies, and summarizes clinical context for appropriate device selection. Data not available in the input is noted where applicable. The content is intended for a national audience of billing specialists, DME suppliers, clinicians, and policy analysts seeking a concise briefing on this HCPCS Level II code and its practical implications.

Billing Code Overview

HCPCS Level II code K0835 describes a power wheelchair, group 2 standard, single power option, sling/solid seat/back, with a patient weight capacity up to and including 300 pounds. This item is a durable medical equipment product intended to provide mobility assistance for patients with mobility limitations.

Service Type: Durable Medical Equipment — Power Mobility Device

Typical Site of Service: Home, outpatient durable medical equipment providers, skilled nursing facilities, and other non-acute care settings

Data not available in the input.

Clinical Context

A typical patient is a 68-year-old individual with progressive mobility limitation from advanced osteoarthritis of the hips and knees and comorbid cardiopulmonary disease who requires a power wheelchair for safe mobility in the community and home. The durable medical equipment supplier conducts a face-to-face evaluation, documents functional limitations (inability to ambulate household distances, unsafe transfers, high energy expenditure with ambulation), measures patient weight (≤300 pounds) and seating needs, and coordinates with the prescribing physician for a written order specifying K0835 (power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds). A mobility specialist assesses seating to determine sling versus solid seat/back preference, programs basic power controls, trains the patient and caregiver on safe operation and battery charging, and arranges delivery to the patient’s residence. Follow-up includes verification of proper fit, pressure distribution education, and documentation of medical necessity for coverage determinations by payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`KJ`	Rental billing modifier (example CMS modifier for reporting rental equipment)	Use when billing a rental period for a power wheelchair under rental payment rules (where applicable by payor).

Taxonomy Code	Specialty	Notes
`251B00000X`	Physical Therapist	Commonly performs mobility assessments, functional testing, and training for power wheelchair use.
`3336C0002X`	Durable Medical Equipment Supplier	DMEPOS suppliers evaluate, furnish, fit, and service power wheelchairs.
`207RH0000X`	Occupational Therapist	Performs seating assessments, activities of daily living evaluation, and caregiver training.
`2080P0208X`	Rehabilitation Physician (PM&R)	Prescribes complex mobility devices and documents medical necessity when comorbid conditions affect mobility.
`207L00000X`	Assistive Technology Professional	Provides advanced seating and mobility customization recommendations.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M16.11`	Unilateral primary osteoarthritis, right hip	Osteoarthritis causing gait impairment and pain that may necessitate a power wheelchair for community mobility.
`M17.11`	Unilateral primary osteoarthritis, right knee	Advanced knee osteoarthritis limiting ambulation and endurance, commonly leading to power mobility device need.
`G82.50`	Paraplegia, unspecified	Neurologic paralysis resulting in loss of lower extremity function, often requiring a power wheelchair for independent mobility.
`G12.21`	Amyotrophic lateral sclerosis	Progressive neuromuscular disease causing severe mobility impairment and need for power wheelchair with appropriate seating.
`R26.2`	Difficulty in walking, not elsewhere classified	Functional gait impairment that may prompt evaluation for durable power mobility equipment.
`Z99.3`	Dependence on wheelchair	Indicates established need for wheelchair mobility, relevant for ongoing equipment provision and replacement.
`I50.9`	Heart failure, unspecified	Cardiopulmonary limitation reducing safe ambulation tolerance and supporting power wheelchair prescription.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97760`	Orthotic(s) management and training, upper or lower extremity, initial; first device	Performed when clinicians provide training and education for use of mobility devices, including initial wheelchair management and functional training.
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	Used for functional mobility and ADL training sessions that support safe use of a power wheelchair.
`97110`	Therapeutic exercises to develop strength, endurance, range of motion and flexibility	Used when therapy sessions address strength and endurance required to operate or transfer to/from the power wheelchair.
`99070`	Supplies and materials (e.g., additional disposable items) provided by the DME supplier over and above the basic service	Used for non-covered accessories or expendable supplies supplied with the wheelchair when billed separately.
`A9270`	Non-covered item or service (miscellaneous DME supply) — HCPCS Category II-like entry used in some billing contexts	Used by suppliers to indicate items or accessories related to the wheelchair that are non-covered by Medicare but billed to secondary payors or patients.

OpenPayer

Summary & Overview

HCPCS K0835: Power Wheelchair Group 2 Standard, 300 lb Capacity