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See a sample rate comparisonHCPCS K0012 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Lightweight portable motorized/power wheelchair
| Key Fact | Detail |
|---|---|
| Service Type | Durable medical equipment (DME) Medicare administrative contractors (MACs) Wheelchairs, Components, and Accessories |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for K0012 |
National average reimbursement for HCPCS K0012 by major payers:
$2,730.84
$1,884.25
$3,465.13
$5,321.74
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HCPCS K0012
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$6,258.12Published rateChristopher Raio
St Francis Hospital
$2,609.58Published rateChristopher Raio
St Francis Hospital
$1,884.69Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$1,046.25Published rateChristopher Raio
St Francis Hospital
$131.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS K0012 vs. Other Wheelchairs, Components, and Accessories Codes
The HCPCS K0012 code is part of the Durable medical equipment (DME) Medicare administrative contractors (MACs) services used for Wheelchairs, Components, and Accessories. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS K0012 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| K0011-HCPCS | High | Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking |
| K0012-HCPCS | High | Lightweight portable motorized/power wheelchair |
| K0013-HCPCS | High | Custom motorized/power wheelchair base |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0012. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0012 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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