Expansion of the Medicare PMD Prior Authorization Program

CMS has announced the expansion of the Medicare Prior Authorization (PA) Program for Power Mobility Devices (PMDs) to 12 additional states starting October 1, 2014. The states to be added include:

  • Arizona
  • Georgia
  • Indiana
  • Kentucky
  • Louisiana
  • Maryland
  • Missouri
  • New Jersey
  • Ohio
  • Pennsylvania
  • Tennessee
  • Washington

CMS data indicates that the 19 states listed above accounted for 71% of Medicare’s payments for PMDs in 2012.

The PMDs affected by the PMD PA expansion included:

  • Group 1 Power Operated Vehicles (K0800 through K0802 and K0812)
  • All standard power wheelchairs (K0813 through K0829)
  • All Group 2 complex rehabilitative power wheelchairs (K0835 through K0843)
  • All Group 3 complex rehabilitative power wheelchairs without power options (K0848 through K0855)
  • Pediatric power wheelchairs (K0890 and K0891)
  • Miscellaneous power wheelchairs (K0898)
    • The policies and processes being used in the current 7 states will be the same used in the additional 12 states.


    Assistance in Navigating the New Medicare Market - Introducing The MOBILITY Consultants, LLC

    Along with products and services to help suppliers thrive, Drive now offers information and a variety of services on Medicare reimbursement and compliance issues through The MOBILITY Consultants, LLC. These added value services can help answer the questions so many suppliers have about the mobility business, increase first time approvals and assist with all audits for Medicare claims.Along with products and services to help suppliers thrive, Drive now offers information and a variety of services on Medicare reimbursement and compliance issues through The MOBILITY Consultants, LLC. These added value services can help answer the questions so many suppliers have about the mobility business, increase first time approvals and assist with all audits for Medicare claims.

    The MOBILITY Consultants is in the business of providing a comprehensive resource for mobility reimbursement and regulatory compliance issues. For more information on The MOBILITY Consultants and a menu of services we offer, visit our website at The MOBILITY Consultants.


    Click here for the announcement published by CMS for additional details.

    Click here for the current PMD PA Demo Operational Guide.


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