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 L33789 and related Policy Article A52498
.
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:
- DME myCGS portal – the fastest, easiest way to submit prior authorization requests and check the status.
- Mail, fax, and esMD – use the Prior Authorization (PA) Submission Form
Resources
- CGS issued a new prior authorization coversheet
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- Prior Authorization HCPCS Look-Up Tool
- Condition of Payment Prior Authorization – Online Education
- Power Mobility Device (PMD) Required Prior Authorization – What Suppliers Need to Know
- Dear Physician – Power Wheelchairs and Power Operated Vehicles
- Dear Physician – Medicare Prior Authorization Condition of Payment for Certain Power Mobility Devices
- Top Reasons for Condition of Payment Power Mobility Device Non-Affirmative Decisions
- Documentation Checklists
- Power Mobility: Group 1 PWCs (K0813 – K0816) & Group 2 PWCs (K0820 – K0829)
- Power Mobility: Group 2 Single Power Option PWCs (K0835 – K0840) & Group 2 Multiple Power Option PWCs (K0841 – K0843)
- Power Mobility: Group 3 No Power Option PWCs (K0848 – K0855), Group 3 Single Power Option PWCs (K0856 – K0860), & Group 3 Multiple Power Option PWCs (K0861 – K0864)
- Power Mobility: POVs (HCPCS Codes K0800 – K0802 and K0806 – K0808)
- Power Mobility: Group 1 PWCs (K0813 – K0816) & Group 2 PWCs (K0820 – K0829)
CMS Resources
- Inclusion of Power Mobility Device Codes in the Prior Authorization Program for DMEPOS Items SE18010
- Operational Guide for PA Process for Certain DMEPOS Items
- FAQs for PA Process for Certain DMEPOS Items
- PA Process for Certain DMEPOS Items
Updated: 12.29.23