Pre-Claim Review

Advance Determination of Medicare Coverage (ADMC) - View information about voluntary program that allows suppliers and beneficiaries to request prior approval of "eligible" items before item delivery

Power Mobility Device (PMD) Prior Authorization Demonstration - On September 1, 2018, PMD HCPCS (K0813-K0829 and K0835-K0855) will become part of the nationwide Required Prior Authorization (PA) program. Effective August 18, 2018, requests for PA review in the demonstration program will no longer be accepted by DME MACs for all HCPCS. View details

Required Prior Authorization Programs - CMS has implemented prior authorization (PA) as a condition of payment for specific HCPCS codes. View details

Last Updated Aug 16, 2018

Comparison Tool

Pre-Claim Review Comparison Tool

Prior Authorization Lookup Tool

Determine which HCPCS codes require a Prior Authorization


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