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.
- 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)
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