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Independence Blue CrossCommercial · Prior Auth · Medical Policy · Physical Therapy, Occupational Therapy, Geriatrics +1 moreMedium impact

05.00.54m, Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Power-Assist System Devices

Effective date
Oct 28, 2026
Identified
Nov 3, 2026

Summary

Independence Blue Cross added face-to-face encounter and written order prior to delivery and/or prior authorization requirements to HCPCS code K0831 (Power wheelchair, group 2 standard, seat elevator, captain's chair, patient weight capacity up to and including 300 pounds) effective 10/28/2026, in accordance with Medicare Final Rule. The billing team must obtain prior authorization before delivering this device and ensure documentation of a face-to-face encounter and written order are in place.

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What to do

Action · 5 steps
01Prior to 10/28/2026 (already effective as of analysis date 2026-11-03): Update charge entry and prior authorization workflows so that HCPCS code K0831 claims are submitted to Independence Blue Cross with prior authorization before delivery.
02Instruct billing team to obtain prior authorization for K0831 before scheduling or arranging delivery for affected members.
03Confirm that providers and suppliers document a face-to-face encounter and written order prior to delivery and include this documentation with the prior authorization request.
04Flag any K0831 claims submitted without prior authorization for appeal or resubmission with authorization.
05Monitor for claim denials on K0831 without prior authorization and contact members to explain the authorization requirement for future orders.

Codes mentioned

K0831

Original notice

05.00.54m, Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Power-Assist System Devices
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
MA05.032e, Power Wheelchairs (PWCs), Power-Operated Vehicles (POVs), and Power-Assist System DevicesMediumEffective Oct 28, 2026 · Medical PolicyMA05.046l, Wheelchair Options and AccessoriesHighEffective Oct 28, 2026 · Medical Policy05.00.67w, Wheelchair Options and AccessoriesHighEffective Oct 28, 2026 · Medical PolicyMA05.026f, Manual WheelchairsHighEffective Oct 28, 2026 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesPhysical TherapyOccupational TherapyGeriatricsPM&R (Physical Medicine & Rehab)Code K0831

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