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

Discontinued December 31, 2018 Carrier judgment

HCPCS codeK0903
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
38 Orthotics, prosthetics, prosthetic devices & vision services
Medicare coverage
C Carrier judgment – coverage decided by the Medicare contractor
BETOS category
D1F Prosthetic/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

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.