Summary
CMS LCD L33789 (Power Mobility Devices, CGS and Noridian DME MACs) is revised with a source-stated effective date of 12/20/2026, after the 11/06/2026 analysis date, so it is not yet in effect. The revision adds coverage criteria (II.A–II.G) for non-complex Group 2 seat elevator power wheelchairs (K0830, K0831) and renumbers subsequent sections, and it states that claims not meeting these criteria will be denied as not reasonable and necessary.
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What to do
Action · 2 steps
01Before 2026-12-20: Billing team should review the revised LCD and confirm current applicability on the CMS coverage database, since the source states this revision is future-effective and the notice period runs through 12/19/2026.
02Providers and front desk staff should be told that non-complex Group 2 seat elevator PWCs (K0830, K0831) will require documentation that the beneficiary relies on the PWC as the primary means of mobility in the home, that upper-extremity transfers or reaching for MRADLs is needed, that substantial mobility assistance is documented on a standardized rating scale, and that a specialty evaluation by an LCMP (PT, OT, or qualifying practitioner with no financial relationship with the supplier) plus an ATP-involved supplier selection are on file; the practice should update its prior-authorization and charge-entry workflow and documentation checklists for these codes, and expect that claims without these elements will be denied as not reasonable and necessary.
Codes mentioned
K0830K0831K0813K0814K0815K0816K0820K0821K0822K0823K0824K0825K0826K0827K0828K0829K0835K0836K0837K0838K0839K0840K0841K0842K0843K0848K0849K0850K0851K0852K0853K0854K0855K0856K0857K0858K0859K0860K0861K0862K0863K0864K0890K0891E0986
Original notice
Power Mobility Devices
cms.gov · Always check the source before changing claims.
Related changes
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Medicare/CMS - LCD policiesPhysical TherapyOccupational TherapyPM&R (Physical Medicine & Rehab)GeriatricsNeurologyCode K0830Code K0831Code K0813Code K0814Code K0815Code K0816Code K0820Code K0821Code K0822Code K0823Code K0824Code K0825Code K0826Code K0827Code K0828Code K0829Code K0835Code K0836Code K0837Code K0838Code K0839Code K0840Code K0841Code K0842Code K0843Code K0848Code K0849Code K0850Code K0851Code K0852Code K0853Code K0854Code K0855Code K0856Code K0857Code K0858Code K0859Code K0860Code K0861Code K0862Code K0863Code K0864Code K0890Code K0891Code E0986