Manual Wheelchair Bases
National · Effective Jan 1, 2020
1 active Medicare policy lists K0004, and 7 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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National · Effective Jan 1, 2020
7 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of K0004 |
|---|---|---|
| Wheelchairs and Power Operated Vehicles (Scooters) | Oct 25, 2023 | Covered |
| Policy | Effective | Status of K0004 |
|---|---|---|
| Wheeled Mobility Devices: Manual Wheelchairs - Standard, Heavy Duty and Lightweight | Jan 6, 2026 | Covered |
| Policy | Effective | Status of K0004 |
|---|---|---|
| Wheelchairs and Accessories | Jan 1, 2026 | Covered |
| Policy | Effective | Status of K0004 |
|---|---|---|
| Wheelchairs and Accessories | Jan 1, 2026 | Covered |
| Policy | Effective | Status of K0004 |
|---|---|---|
| Wheelchairs and Accessories | Jan 1, 2026 | Covered |
| Policy | Effective | Status of K0004 |
|---|---|---|
| Wheelchairs and Accessories | Jan 1, 2026 | Covered |
| Policy | Effective | Status of K0004 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List | Jan 1, 2025 | Prior auth required |