K0462 Temporary replacement eqpmnt

Temporary replacement for patient owned equipment being repaired, any type

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for K0462

Payer coverage policies that name K0462

K0462 appears in 3 coverage policies from Blue Shield of California, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
Blue Shield of CaliforniaBSC1.02 Power Wheelchairs and Power Operated Vehicles for Permanent Uselisted, no stancepayer document
Capital Blue CrossManual Wheelchairs and Accessories (MP 6.059)covered if criteria are metSep 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Wheelchairs and Accessories (DME101.010)
HCPCS Codes E0950, E0951, E0952, E0953, E0954, E0955, E0956, E0957, E0958, E0959,		listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in CO, IL, IN, KY.

  • CO: $158.07 (health_first_colorado), effective Jul 1, 2026
  • TX: $48.76 (dmepos_tos_9_e_j_l_and_r, Home Health Dme), effective Mar 1, 2012
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.