Skip to Main Content

September 2, 2026

Probationary Period of Prior Authorization for Certain Newly Enrolled DMEPOS Suppliers – Starting October 15, 2026

Effective October 15, 2026, CMS is implementing a nationwide, one-year probationary period for newly enrolled DMEPOS suppliers and those undergoing changes of ownership.

Under Probationary Prior Authorization (PPA), these suppliers must submit Prior Authorization Requests (PARs) for specific HCPCS codes across all states and territories.

Who Must Submit Prior Authorizations

This prior authorization requirement only applies to:

  • Newly enrolled suppliers
  • Suppliers that undergo a 100% change in ownership

Items that Require Prior Authorization

  • Osteogenesis Stimulators: E0747, E0748
  • Ankle-Foot/Knee-Ankle-Foot Orthoses: L1902, L1906, L1971, L2035, L2132, L2134, L2136, L4360, L4361, L4396, L4397
  • Knee Orthoses: L1810, L1812, L1820, L1821
  • Lower Limb Orthoses: L1652, L1653, L1686, L1690
  • Spinal Orthoses: L0626, L0627, L0628, L0630, L0633, L0635, L0641, L0642, L0643, L0649, L0720
  • Upper Limb Orthoses: L3660, L3670, L3760, L3762, L3809, L3908, L3915, L3960

CGS will share more information as it becomes available. Check our Prior Authorization page and Jurisdiction C News page for updates. Make sure you are signed up for Electronic Mailing List to get direct email notifications.

spacer

26 Century Blvd, Suite NT600, Nashville, TN 37214 © CGS Administrators, LLC. All Rights Reserved