I've always had 20" wheels and this was never an issue. As already mentioned its the bed and suspension on newer trucks that raise the height. My 2012 bed height is higher than my 2006 F350; same wheels and tires. There are several adjustments options to have it work and set level and depending on the fiver you may need to make adjustments on both the hitch and fiver. Our previous fiver we just had the axle springs flipped. With my current fiver I swapped out the hitch for one that has more adjustment play for raising or lowering.