Article Detail - JA DME
Updates to the Master List and Required Prior Authorization List Effective August 12, 2024
On May 13, 2024, CMS announced updates to the Master List and the Required Prior Authorization List. The following changes will be effective August 12, 2024:
Orthoses:
Medicare will no longer require prior authorization and face-to-face encounter and Written Order Prior to Delivery (WOPD) for HCPCS code L1833.
CMS included six additional orthosis HCPCS codes (L0631, L0637, L0639, L1843, L1845, L1951) for required prior authorization to begin nationwide.
Osteogenesis Stimulators:
CMS included three additional osteogenesis stimulator HCPCS codes (E0747, E0748, E0760) subject to required prior authorization.
There will be two phases of implementation for the newly added codes:
Phase one begins August 12, 2024, in California, Florida, Ohio, and Pennsylvania.
Phase two begins November 12, 2024, in all remaining states and territories not included in phase one. For more information review CMS website for Master List of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items Potentially Subject to Conditions of Payment.
