Power Mobility Device Prior Authorization Demonstration

On September 1, 2018, Power Mobility Device (PMD) HCPCS codes (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 codes. DME MACs will begin accepting PA review requests under the Required PA program August 18, 2018 for planned dates of service on/after September 1, 2018.

DME MACs will honor PAR Demonstration decisions rendered prior to September 1, 2018.

Access the below related information from this page.

Background

On September 1, 2012, CMS implemented a PAR process for designated PMDs for Medicare beneficiaries residing in seven high population states including California, Illinois, Michigan, New York, North Carolina, Florida, and Texas.

On October 1, 2014, the PAR demonstration expanded to an additional twelve states including Washington, Missouri, Arizona, Pennsylvania, Maryland, New Jersey, Indiana, Louisiana, Tennessee, Georgia, Ohio and Kentucky.

On September 1, 2015, the PAR demonstration was extended for an additional three years and will end August 31, 2018. See the CMS Prior Authorization of PMD Demonstration webpage for more information.

Noridian processes PARs for beneficiaries residing in Arizona, California, Missouri, and Washington.

Resources

Last Updated Aug 15, 2018