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...

Article

From Recovery to Prevention: APTA Report Charts New Course For Public Awareness

Oct 15, 2025

A newly released research report, APTA’s Consumer Perceptions Report, sheds light on how Americans perceive physical therapy — and where opportunities

Article

Cigna Implements Outpatient Hospital Physical Therapy Site-of-Care Review

Oct 14, 2025

Effective Oct. 1, Cigna Healthcare implemented a new site-of-care review process for outpatient hospital physical therapy and occupational therapy

News

APTA Advocacy Leads to Noridian Updated Guidance on Plan of Care Signature

Oct 14, 2025

On Sept. 10, the Medicare Administrative Contractor Noridian Healthcare Solutions amended its existing guidance on the regulations governing certification