K0901 HCPCS Level II code: Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation…
CMS terminated K0901: its last date of service was Dec 31, 2016. It stays here for looking up older claims; newer services need a current code.
Official description
K0901Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Short description: Ko single upright pre ots
HCPCS · United States
Medicare details
The indicators CMS publishes with K0901 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- DMEPOS fee schedule – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
- Type of service
- Lump sum purchase of DME, prosthetics, orthotics
- BETOS category
- Prosthetic/Orthotic devices
- Cross-reference
- See L1851
- Added
- Oct 1, 2014
- Terminated after
- Dec 31, 2016
Where K0901 sits
- 1K codesTemporary codes for DME
- 2Terminated K0901Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
Is HCPCS code K0901 still valid?
No. CMS terminated K0901; its last date of service was Dec 31, 2016. It is listed for looking up services from before then. Use a current code for newer services.
Does Medicare cover K0901?
CMS lists K0901’s Medicare coverage as “Carrier judgment” and its pricing as “DMEPOS fee schedule – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside K0901
All K codesK0886Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 poundsK0890Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 poundsK0891Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 poundsK0898Power wheelchair, not otherwise classifiedK0899Power mobility device, not coded by dme pdac or does not meet criteriaK0900Customized durable medical equipment, other than wheelchairK0902Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without…K0903For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact…K1001Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any typeK1002Cranial electrotherapy stimulation (ces) system, any typeK1003Whirlpool tub, walk-in, portableK1004Low frequency ultrasonic diathermy treatment device for home use