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Power Mobility Device (PMD) Required Prior Authorization

CMS requires prior authorization of these PMD HCPCS codes for all states and territories: K0800-K0802, K0806 -K0808, K0813-K0829, K0835-K0843, and K0848-K0864.

We will base the prior authorization decision on coverage criteria found in the PMD LCD L33789External website and related Policy Article A52498External website.

Visit the Power Mobility Device Accessory Voluntary Prior Authorization page for information on including accessories with the request.

How to Submit a Prior Authorization Request:


CMS Resources

Updated: 12.29.23


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