CMS Expands its Prior Authorization Program for Orthotics and Power Mobility

According to CMS, the prior authorization program:

  • Helps to protect the Medicare Trust Fund from improper payments
  • Ensures that beneficiaries receive DMEPOS items they need in a timely manner.

CMS moved six power operated vehicle (POV) codes and five orthotics codes from the Master List to the CMS Required Prior Authorization List. The effective dates of service are:

  • POVs - April 13, 2022
  • Orthotics - on or after April 13, 2022, depending on the state

You will find the PA Process for Certain DMEPOS Items Operational Guide and Frequently Asked Questions pages CMS has published very helpful.

Last Updated Apr 05 , 2022