Manual Wheelchairs
CMS requires prior authorization for the following manual wheelchair for all states and territories:
- K0005 (Effective October 28, 2026 Nationwide)
We will base the prior authorization decision on Manual Wheelchair Bases LCD L33788
and related Policy Article A52497
.
How to Send Your Request
|
When to Expect the DecisionWe will send a detailed decision letter by the fifth business day, not to exceed seven calendar days following receipt of a request. Expedited requests: If there is a valid need for an expedited review, we will make reasonable efforts to send a decision within two business days. |
Deliver Within 6 Months
Prior authorization decisions for the K0005 are valid for 6 months after the provisional affirmation review decision. If the supplier doesn't deliver the K0005 within 6 months of the decision, the supplier needs to send another prior authorization request.
Resources
- Dear Physician Letter – Manual Wheelchairs

- Manual Wheelchair Documentation Checklist

- Wheelchair FAQs
- Standard Elements for DMEPOS Order, and Master List of DMEPOS Items Potentially Subject to a Face-to-Face Encounter and Written Orders Prior to Delivery and, or Prior Authorization Requirements
[MLN SE20007]
Updated: 09.09.2026


