K1004 — Low frequency ultrasonic diathermy treatment device for home use
K1004 is a HCPCS Level II code for low frequency ultrasonic diathermy treatment device for home use. It belongs to the Durable Medical Equipment (DME MAC Temporary) section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Non-covered by statute
Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one — an ABN is the relevant conversation.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of K1004 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for K1004
- Long descriptor
- Low frequency ultrasonic diathermy treatment device for home use
- Short descriptor
- Lo freq us diathermy device
- Added
- January 1, 2020
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to K1004
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If K1004 is not quite right, the correct code is very often within a few positions of it.
- K0899Power mobility device, not coded by dme pdac or does not meet criteria
- K0900Customized durable medical equipment, other than wheelchair
- 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-shelfterminated
- K0902Knee 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-shelfterminated
- 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 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, eachterminated
- K1001Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any typeterminated
- K1002Cranial electrotherapy stimulation (ces) system, any typeterminated
- K1003Whirlpool tub, walk-in, portableterminated
- K1005Disposable collection and storage bag for breast milk, any size, any type, eachterminated
- K1006Suction pump, home model, portable or stationary, electric, any type, for use with external urine management systemterminated
- K1007Bilateral 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
- K1009Speech volume modulation system, any type, including all components and accessoriesterminated
- K1010Indwelling intraurethral drainage device with valve, patient inserted, replacement only, eachterminated
- K1011Activation device for intraurethral drainage device with valve, replacement only, eachterminated
- K1012Charger and base station for intraurethral activation device, replacement onlyterminated
- K1013Enema tube, with or without adapter, any type, replacement only, eachterminated
Questions about K1004
What is HCPCS code K1004?
K1004 is a HCPCS Level II code for low frequency ultrasonic diathermy treatment device for home use. It sits in the Durable Medical Equipment (DME MAC Temporary) section.
Does Medicare cover K1004?
The CMS HCPCS file marks K1004 as "Non-covered by statute". Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one — an ABN is the relevant conversation.