Skip over navigation

Required Prior Authorization Programs - JD DME

Required Prior Authorization Programs

CMS issued a final rule that established a prior authorization (PA) process as a condition of payment for certain DMEPOS items that are frequently subject to unnecessary utilization.

The Master List contains the DMEPOS items identified as being frequently subject to unnecessary utilization; however, presence on this list does not automatically create a PA requirement for that item. CMS will implement a subset of items from the Master List (referred to as the "Required Prior Authorization List") and publish in the Federal Register with at least 60 days' notice before PA implementation of those items.

Access the below related information from this page.

Prior Authorization Timelines

Policy Initial Review
Decision Timeframe
Expedited Review
Decision Timeframe
PAR Decision
LLP 10 business days 2 business days 120 days
Orthoses 5 business days 2 business days 60 days
PMD 10 business days 2 business days six months
PRSS 5 business days 2 business days one month




Last Updated Tue, 04 Oct 2022 14:58:59 +0000

The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.

paginationType noridian