Dynamic List Information
Dynamic List Data
HCPCS Code
K0855
On Master List?
Yes
Prior Authorization Required?
Yes
PA Effective Dates
9/01/18 Nationwide
F2F and Written Order Prior to Delivery?
Yes
F2F and WOPD Effective Dates
4/17/23
Description: Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more