Summary & Overview
HCPCS K0878: Power Wheelchair Group 4 Standard, Captain's Chair, up to 300 lb
HCPCS Level II code K0878 denotes a Group 4 standard power wheelchair with a single power option and captain's chair, rated for patients up to and including 300 pounds. This code identifies a commonly used durable medical equipment (DME) item that supports mobility and functional independence for individuals with significant mobility limitations. Nationally, power wheelchairs are a key component of mobility benefit management and have implications for durable medical equipment policy, supplier requirements, and payer coverage determinations.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise summary of what the code represents, typical settings for use, and the clinical context for why such devices are prescribed. The publication also outlines what to expect in payers' coverage approaches, common billing modifiers, and areas where policy updates may affect claims processing.
This report is intended for providers, billing staff, DME suppliers, and policy analysts seeking a national-level reference on classification and operational considerations for HCPCS Level II code K0878. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code K0878 describes a power wheelchair, group 4 standard, single power option, captain's chair, with a patient weight capacity up to and including 300 pounds. This item is a durable medical equipment mobility device intended to provide powered mobility for individuals with mobility impairments who require a standard Group 4 power wheelchair configuration.
Service type: Durable Medical Equipment — Power Mobility Device
Typical site of service: Patient home or community settings where durable medical equipment is used, including residences and long-term care facilities.
Clinical & Coding Specifications
Clinical Context
A patient with limited mobility related to neuromuscular disease, severe osteoarthritis, morbid obesity, or spinal cord injury is evaluated for durable medical equipment and determined to require a Group 4 power wheelchair. The ordering clinician (physiatrist, neurologist, orthopedist, or primary care physician) documents functional deficits such as inability to ambulate safely, profoundly limited endurance, and need for mobility for activities of daily living. A mobility assessment by a therapist (occupational or physical therapist) documents seating, positioning, and driving controls appropriate for a single power option and a captain's chair. A supplier verifies patient weight at or below 300 pounds and configures a Group 4 standard power wheelchair with required accessories.
Clinical workflow:
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Referral and evaluation: Provider documents medical necessity, history, physical exam, and functional limitations supporting power mobility.
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Mobility assessment: Therapist completes a standardized mobility assessment, wheelchair measurements, and trial of power seating/controls when indicated.
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Prior authorization: Supplier submits documentation (physician order, therapy assessment, supporting diagnoses, photos/measurements) to the payor (for example: Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthCare, BUCA, Medicare) for medical necessity review.
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Delivery and training: Upon approval, supplier configures and delivers the
K0878power wheelchair, provides patient and caregiver training, and documents delivery, setup, and gait/transfer training if needed. -
Follow-up and maintenance: Supplier documents any adjustments, repairs, or modifications; clinicians document ongoing need in medical record for durable medical equipment coverage and potential future repairs or replacement.