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

Online Event to Explore Report on Virtual MSK Care

Jun 10, 2024

Join us June 27 for a live online discussion on the recently released report confirming that virtual health technologies, when guided by a PT, deliver

Open Access

Improved Outcomes With PT-Guided Virtual MSK Care

Jun 5, 2024

The independent evaluation supports APTA’s position that digital physical therapy services only be performed or directed by licensed PTs.

Statement

PHTI's Report on Virtual Musculoskeletal Solutions Health Technology Assessment

Jun 5, 2024

The following statement was released today by American Physical Therapy Association President Roger Herr, PT, MPA.