Skip to main content

Physical therapists (PTs) who are providers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) take note: the US Centers for Medicare and Medicaid Services (CMS) is adding 31 codes to its list of devices that require prior authorization under Medicare. The additional codes will go into effect on September 1 of this year.

The codes, all related to power wheelchairs, already were subject to prior authorization in 18 states as part of a demonstration project aimed at reducing improper payment. With that demonstration project set to end on August 31, CMS decided to expand the requirements to all states and fold the list into its broader DMEPOS demonstration project launched in 2015.

CMS offers a webpage focused on the DMEPOS prior authorization program and has published a notice and list of the 31 codes to be added. A full list of DMEPOS requiring prior authorization (minus the 31 codes to be added in September) is also available from CMS.


You Might Also Like...

News

ONC, HHS Finalize Penalties for Information Blocking Violations

Jul 25, 2024

Violating info blocking rules could impact a PT’s participation in the CMS Quality Payment Program; see APTA's updated Practice Advisory.

Article

Information Blocking

Jul 25, 2024

Federal regulations are in place to guard against providers intentionally interfering with or discouraging patient access to electronic health information.

News

APTA-Backed Legislation Improves Veterans' Access to Falls Prevention Services

Jul 22, 2024

The bipartisan bill would establish an Office of Falls Prevention within the Veterans Health Administration.