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General billing-reference information, not medical or legal advice. Payment rules are set by Medicare; the contractor pages cited below are the authoritative lookup for a specific claim.
Short answer
The KU modifier is a Medicare billing modifier that tells the claims system to pay a wheelchair accessory or seat and back cushion at the unadjusted fee schedule amount. It applies to accessories and cushions furnished with complex rehabilitative manual wheelchairs and certain other manual wheelchairs, and it continues to be used with Group 3 power wheelchairs. Source: Noridian JD DME, “Modifier KU” (page last updated May 30, 2025; checked November 1, 2026).
Definition and scope
A HCPCS modifier is a two-character addition to a product code that gives the payer extra information about how the item was furnished or how it should be paid. KU is one of several modifiers used on durable medical equipment (DME) claims. For NU, UE, RR, KH, KI, KJ and KX, which are a different group, see DME modifiers explained; this page covers only KU.
Noridian, the Medicare contractor for DME Jurisdiction D, describes KU as “used to receive the unadjusted fee schedule amount” and says it was implemented for “a variety of wheelchair accessories and seat back cushions used with complex rehabilitative manual wheelchairs and certain manual wheelchairs.”
CGS, another Medicare contractor, explains the reason: beginning July 1, 2021, CMS continued the payment rates established by section 106 of the Further Consolidated Appropriations Act, 2020, which excludes wheelchair accessories and back and seat cushions used with the covered manual wheelchairs from the application of adjusted fee schedule amounts (CGS, “KU Modifier for Accessories Used in Conjunction with Complex Rehabilitative Manual Wheelchairs and Certain Other Manual Wheelchairs,” June 2021, updated July 15, 2021; checked November 1, 2026).
How the KU modifier is used in practice
The modifier attaches to the accessory or cushion line, not to the wheelchair base. Per CGS, suppliers should use KU on claims for accessories and seat and back cushions furnished in connection with the listed wheelchair base codes. The fee schedule amounts for those items are then based on the unadjusted amounts, updated by the covered item updates in section 1834(a)(14) of the Act.
Noridian adds two details. First, MLN Matters Article MM12453, published October 1, 2021 with an implementation date of October 4, 2021, directs suppliers to continue including KU when billing the manual and power wheelchair accessory and seat and back cushion codes furnished with these wheelchairs. Second, the list of accessory and cushion codes furnished with Group 3 power wheelchairs (HCPCS K0848-K0864) is in Attachment A of CR 12453.
Which wheelchair codes are involved
| Wheelchair type | Base codes named by the contractors | Source |
|---|---|---|
| Manual wheelchairs (complex rehabilitative and certain others) | E1161, E1231 through E1238, K0005, K0008 | Noridian; CGS |
| Group 3 power wheelchairs | K0848 through K0864 | Noridian |
Timeline, 2020 to 2021
| Date | What the sources say | Source |
|---|---|---|
| January 1, 2020 | Previously paid claims with dates of service on or after this date can be reopened to add the KU modifier | Noridian |
| May 7, 2020 | CMS issued Change Request 11635, Transmittal 10019, whose Attachment A lists the manual wheelchair accessory codes eligible for KU | CGS |
| July 6, 2020 | Use of the KU modifier started for claims submitted | Noridian |
| July 1, 2021 | CMS continued the section 106 payment rates; suppliers continue using KU for dates of service on or after this date | CGS |
| July 6, 2021 | Use of KU extended | Noridian |
| October 1 and 4, 2021 | MM12453 published (October 1) with implementation on October 4; KU continues on manual and power wheelchair accessory and cushion codes | Noridian |
Which wheelchair accessories require the KU modifier?
The accessories and seat and back cushions that are furnished with the base codes above and that appear on the CMS attachment lists. For manual wheelchairs, CGS points to Attachment A of Change Request 11635 (Transmittal 10019) for the complete list of eligible accessory codes for dates of service on or after January 1, 2020. For Group 3 power wheelchairs, Noridian points to Attachment A of CR 12453. This page does not reproduce those code lists; check them directly, because membership in the list is what decides whether an accessory line carries KU.
Where it matters for labs, clinics and supply decisions
KU is a supplier-side billing detail: it matters to staff who prepare Medicare claims for wheelchair accessories and cushions, and to clinics that order them. The two contractor pages support a short claim-review checklist.
- Base code: is the wheelchair furnished under E1161, E1231-E1238, K0005 or K0008 (manual), or K0848-K0864 (Group 3 power)?
- Accessory code: is the accessory or seat and back cushion code on the relevant CMS Attachment A list?
- Modifier present: does that accessory line carry KU?
- Date of service: Noridian states that previously paid claims with dates of service on or after January 1, 2020 can be reopened to add the modifier.
- Contractor: use the page of the Medicare contractor that processes the claim; Noridian and CGS each publish their own guidance and lookup tools.
For how Medicare treats DME more broadly, see Medicare DME coverage. For the equipment itself, what a wheelchair is gives plain-language background. Code-set background is in HCPCS versus CPT codes.
Common misunderstandings
KU is not a modifier for the wheelchair itself
The sources describe KU as applying to accessories and seat and back cushions furnished with the listed base codes, not to the base chair.
KU is a payment-basis modifier
The sources describe KU in terms of which fee schedule amount is used (unadjusted rather than adjusted). They do not describe it as a coverage or medical-necessity modifier. Coverage requirements are separate; see the KX modifier guide at HCPCS modifier KX for a different modifier that signals requirements were met.
It is not a 2020-only rule
The timeline above shows the KU instruction was extended in July 2021 and carried forward by MM12453 in October 2021, and Noridian’s page, last updated May 30, 2025, still presents it as current guidance.
FAQ
What does the KU modifier mean?
It indicates that the unadjusted fee schedule amount applies to a wheelchair accessory or seat and back cushion furnished with a listed complex rehabilitative manual wheelchair, certain other manual wheelchairs, or a Group 3 power wheelchair (Noridian; CGS).
What modifiers does Medicare accept?
Medicare accepts many HCPCS modifiers, each tied to particular items or situations, so no single short list answers the question. KU is specific to the wheelchair accessories described here. The common DME modifiers NU, UE, RR, KH, KI, KJ and KX are covered in DME modifiers explained.
Which wheelchair accessories require the KU modifier?
Accessories and seat and back cushions furnished with the base wheelchair codes listed above and included on the CMS Attachment A lists (Change Request 11635 for manual wheelchairs; CR 12453 for Group 3 power wheelchairs).
Can a claim paid without KU be corrected?
Noridian states that previously paid claims with dates of service on or after January 1, 2020 can be reopened to add the KU modifier.
Sources
- Noridian Healthcare Solutions, JD DME, “Modifier KU”: https://med.noridianmedicare.com/web/jddme/topics/modifiers/ku (last updated May 30, 2025; checked November 1, 2026).
- CGS Medicare, “KU Modifier for Accessories Used in Conjunction with Complex Rehabilitative Manual Wheelchairs and Certain Other Manual Wheelchairs”: https://www.cgsmedicare.com/jc/pubs/news/2021/06/cope22524.html (June 2021, updated July 15, 2021; checked November 1, 2026).
