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

APTA, AMA, Others Demand Action From Congress to Address Fee Schedule

Mar 10, 2025

Providers and patients are urged to call Congress on the proposed spending package before March 14 deadline.

Statement

Medicare Physician Fee Schedule Cuts: A Call to Action from APTA's President

Mar 10, 2025

A Call to Action from APTA President Kyle Covington, PT, DPT, PhD

News

PTJ: New Workforce Forecast Projects PT Shortages Through 2037

Mar 4, 2025

Original survey data from APTA provides unique input to the forecast’s findings.