Prior Authorization (PAR) Is Required Nationwide for Five Orthotics Codes

Five orthotics codes were added to the CMS Required Prior Authorization List. This was a phased in implementation beginning in April 2022 for four states. The implementation schedule has been completed so PAR is now a requirement nationwide. The codes requiring PAR include spinal orthotics L0648 and L0650 and knee orthotics L1832, L1833, and L1851. Our Prior Authorization for Orthoses webpage houses the following information:

  • Codes and Descriptions
  • Implementation Schedule
  • Documentation to Include in Submission
    • Methods of Submission
  • Expedited Request Guidelines
  • Avoid Request Rejections
  • Documentation and Modifier Requirements to Bypass Prior Authorization
  • Affirmative and Non-Affirmative Decisions
  • Decision Letter
  • Many Educational Resources

Note: L0648, L0650, L1833, and L1851 are also part of the Competitive Bid program. Comprehensive information and resources are available on the Noridian Competitive Bidding Program webpage.

Last Updated Dec 29 , 2022