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

Telehealth, PT Compact Legislation Reintroduced in U.S. Congress

Apr 9, 2025

Two APTA-supported bills from Congress' last session are back for consideration: making Medicare telehealth provisions permanent for PT services and streamlining

Article

APTA Town Hall: Provide Your Input on Draft Code of Ethics for the Profession

Apr 1, 2025

Join one of two virtual town halls in April to add your thoughts to the Board motion being brought to the 2025 House of Delegates.

Feature

Dealing With Debt

Apr 1, 2025

How students and early-career PTs and PTAs can manage student loans.