Condition of Payment Prior Authorization Expanding to Include Remaining Power Mobility Devices HCPCS Codes - Effective for Dates of Service on/after July 22, 2019

Seven additional Power Mobility Device (PMD) HCPCS codes, K0857-K0860 and K0862-K0864, will be added to the nationwide Condition of Payment Prior Authorization (COPPA) program as stated in the Federal Registry Notice posted April 22, 2019.

DME MACs will:

  • begin accepting Prior Authorization (PA) review requests for these codes under the COPPA program July 8, 2019 for planned dates of service on/after July 22, 2019
  • honor Advance Determination of Medicare Coverage (ADMC) decisions on ADMC requests submitted for review prior to July 8, 2019

View the Prior Authorization for Power Mobility Devices webpage for information related to the PA request process, links to educational resources, and common reasons for non-affirmation of requests.

Last Updated Jun 06, 2019