Prior Authorization for Pressure Reducing Support Surfaces - JD DME
Prior Authorization for Pressure Reducing Support Surfaces
The CMS final rule 42 CFR §§405 and 414., in 2016, established a Prior Authorization (PA) process for certain DMEPOS that are frequently subject to unnecessary utilization. In 2019 it expanded nationwide to include Pressure Reducing Support Surfaces (PRSS) HCPCS codes E0193, E0277, E0371, E0372, and E0373 for new rental series claims.
Beginning October 28, 2026, prior authorization for the E0194 air fluidized bed will be required nationwide.
Prior Authorization Timelines
| Policy | Initial Review Decision Timeframe | Expedited Review Decision Timeframe | PAR Decision Valid |
|---|---|---|---|
| PRSS | 5 business days (not to exceed 7 calendar days) | 2 business days | one month |
Access the below related information from this page.
Documentation to Include for Submission
For documentation requirements, refer to the Browse by DMEPOS Category web page for pressure reducing support surfaces
Decision Letters
Treating practitioners involved in the submission of a prior authorization may request a copy of the decision letter.
- Treating practitioner requesting the letter must be able to demonstrate a legitimate, specific need for information requested
- Request may be sent in with PA request or separately
Still Have Questions?
Call the Supplier Contact Center or Interactive Voice Response (IVR).
