K0903 – For 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 with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
HCPCS Level II code · K codes: Temporary Codes for DME
- Long description
- For 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 with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
- Short description
- Mult den insert dir carv/cam
- Pricing indicator
38Orthotics, prosthetics, prosthetic devices & vision services- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
D1FProsthetic/Orthotic devices- Added
- April 1, 2018
- Last change
- January 1, 2019 – No change
- Termination date
- December 31, 2018
Frequently asked questions
What is HCPCS code K0903?
K0903 is a HCPCS Level II code for for 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 with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each. It was discontinued on December 31, 2018.
Does Medicare cover K0903?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby K codes
- K0886 – Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0890 – Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
- K0891 – Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
- K0898 – Power wheelchair, not otherwise classified
- K0899 – Power mobility device, not coded by dme pdac or does not meet criteria
- K0900 – Customized durable medical equipment, other than wheelchair
- K0901 – Knee 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
- K0902 – Knee orthosis (ko), double 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
- K1001 – Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
- K1002 – Cranial electrotherapy stimulation (ces) system, any type
- K1003 – Whirlpool tub, walk-in, portable
- K1004 – Low frequency ultrasonic diathermy treatment device for home use
- K1005 – Disposable collection and storage bag for breast milk, any size, any type, each
- K1006 – Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
- K1007 – Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors
- K1009 – Speech volume modulation system, any type, including all components and accessories
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.