Power Mobility Device (PMD) Prior Authorization
On September 1, 2012, CMS implemented a Prior Authorization Request (PAR) process for designated Power Mobility Devices (PMDs) for Medicare beneficiaries residing in seven high population states including California, Illinois, Michigan, New York, North Carolina, Florida, and Texas.
On October 1, 2014, the PAR demonstration expanded to an additional twelve states including Washington, Missouri, Arizona, Pennsylvania, Maryland, New Jersey, Indiana, Louisiana, Tennessee, Georgia, Ohio and Kentucky.
On September 1, 2015, the PAR demonstration was extended for an additional three years and will end August 31, 2018. See Prior Authorization of PMD Demonstration on the CMS website for more information.
Noridian Healthcare Solutions processes PARs for beneficiaries residing in Maryland, New Jersey, Pennsylvania and New York.
PMD Coverage Resources
|NCD 280.3||National Coverage Determination (NCD) for Mobility Assistive Equipment|
|L33789 and A52498 [PDF]||Power Mobility Devices Local Coverage Determination (LCD) and Policy Article|
The prior authorization process under this demonstration is available for the following Healthcare Common Procedure Coding System (HCPCS) codes for Medicare payment:
|Group 1 Power Operated Vehicles||K0800, K0801, K0802, K0812|
|All Group 2 complex rehabilitative power wheelchairs||K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843|
|Pediatric power wheelchairs||K0890, K0891|
|All standard power wheelchairs||K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829|
|All Group 3 complex rehabilitative power wheelchairs without power options||K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855|
|Miscellaneous power wheelchairs||K0898|
Last Updated Jul 07, 2016