Effective October 15, 2026, the Centers for Medicare & Medicaid Services (CMS) will implement a nationwide one-year probationary prior authorization (PPA) process for newly enrolled suppliers and suppliers undergoing a change of ownership. Additionally, prior authorization will be required as a condition of payment for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS; www.cms.gov/files/document/dmepos-probationary-prior-authorization-code-list.pdf ) items with dates of services on or after October 15, 2026.
New and change of ownership suppliers are also subject to regular program oversight initiatives, including the following requirements:
- Required prior authorization
- Face-to-face encounter
- Written order prior to delivery
For more information, visit the webpages for PPA Process for Newly Enrolled Suppliers of Certain DMEPOS Items, Prior Authorization Process for Certain DMEPOS Items, DMEPOS Order & Face-to-Face Encounter Requirements, and MLN Matters® Article SE20007.
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