HCPCS Code K0823: Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds

Discover HCPCS Code K0823 power wheelchair with captain’s chair, designed for patients up to 300 lbs needing mobility support.

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## **What is this group-2 standard power wheelchair?** HCPCS code K0823 describes a power wheelchair, group 2 standard, with a captain’s chair and patient weight capacity up to and including 300 pounds, a durable medical equipment (DME) item for patients who need a motorized wheelchair for in-home mobility. Group-2 chairs provide basic powered mobility (e.g., joystick control, programmable control parameters, propulsion wheel systems, and battery charger) without complex rehab features; they are different from Group-3 chairs that support multiple power seating options. Coverage hinges on the power mobility devices (PMD) LCD criteria and clinical documentation showing the patient cannot use a manual wheelchair or scooter safely and effectively in the home (LCD - Power Mobility Devices (L33789), n.d.). K0823 models are supplied as a power mobility base with standard seating (captain’s chair) and fixed mounting hardware; accessories like leg rests may vary by supplier. Under Medicare’s PMD policy, Group-2 standard power wheelchairs (including K0823) are capped-rental items rather than immediate purchases, and many plans require prior authorization before delivery. Always verify plan rules, since payer lists and PA requirements can differ (Power Mobility Devices (PMDS) - JD DME - Noridian, n.d.).

## **Documentation requirements** When billing HCPCS code K0823 (power wheelchair, group 2 standard, captain’s chair, up to 300 lbs patient weight capacity), providers must ensure that medical records include the following elements: ### **Physician evaluation** A face-to-face mobility evaluation by the physician or other qualified provider must be performed within six months of the order. This evaluation should clearly establish the medical necessity of a power wheelchair group 2 standard device and explain why a manual wheelchair, scooter, or lesser device is insufficient for the patient’s mobility-related activities of daily living. ### **Detailed written order (DWO)** A detailed written order must be completed and signed by the physician. The DWO should include: - The specific HCPCS code (K0823 CPT code description). - Confirmation that the device requested is a standard Group 2 power wheelchair with a captain’s chair, as defined by the HCPCS code description. - Any additional features requested (e.g., power recline functions beyond the basic captain’s chair, specialized leg rests, or other mounting hardware), with documentation noting that these are billed separately under their own HCPCS accessory codes. ### **Patient weight and capacity** Documentation must show that the patient's weight capacity does not exceed 300 pounds, as required under the K0823 code description. ### **Home assessment** A home assessment must confirm that the patient’s environment can safely support the use of a motorized wheelchair, including doorway widths, flooring, and layout for turning radius. ### **Supporting medical necessity** Providers must document: - The diagnosis or condition requiring powered mobility. - The functional limitations (e.g., inability to self-propel a manual wheelchair). - Any previous attempts with a manual wheelchair or alternative mobility device. ### **Additional notes** - If programmable control parameters, gear reduction drive wheel, acceleration control functions, or power add-on features are requested, these must be justified. - Documentation should also include evidence that the patient can safely operate the device with joystick control or other adaptive controls. - Prior authorization is often required by Medicare Advantage or other health plans, so providers should confirm requirements before delivery.

## **Billing requirements** - **Unit of service**: Bill 1 unit per wheelchair. - **Place of service**: Typically home use (POS 12). - **Modifiers**: Use NU (new equipment), UE (used equipment), or RR (rental) as appropriate. - **Prior authorization**: Required under Medicare in most states for K0823. - **Rental vs. purchase**: Medicare generally applies a capped rental policy—the chair is rented up to 13 months before converting to purchase. - **Covered accessories**: Items like batteries, chargers, seat belts, or power options must be billed separately under their specific HCPCS codes.

## **Other relevant codes** - K0823 - Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 - K0821 - Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and incl - K0816 - Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 - K0849 - Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 - K0825 - Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds

### **References** LCD - Power Mobility Devices (L33789). (n.d.). https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33789 Power Mobility Devices (PMDS) - JD DME - Noridian. (n.d.). JD DME. https://med.noridianmedicare.com/web/jddme/dmepos/pmds

Frequently asked questions

K0823 is a standard, non-portable Group 2 power wheelchair with a captain’s chair, while K0821 is the portable version of a Group 2 standard chair. Neither code automatically includes advanced power seating features. However, accessories such as a seat elevator, manual standing system, or speed adjustment may be added to either model when medically justified and billed under their own HCPCS codes. The key difference is portability, not the presence of built-in power options.

Yes. Medicare requires prior authorization for most power mobility devices, including K0823. Documentation must show why a patient cannot safely use or convert a manual wheelchair instead.

No. Since the patient weight capacity is up to 300 lbs, those exceeding this limit must be considered under bariatric or extra heavy-duty power wheelchair codes.