The master list is already provided in the final notice and includes common products such as the E0601 (CPAP), E0260 (semi-electric hospital bed), E0277 (group 2 support surface), K0004 (manual wheelchair), multiple power wheelchair codes, multiple lower limb prosthesis codes and more. As a surprise update, CMS opted to remove five lower limb HCPCS that were included in the proposed rule but decided to add the E1390 oxygen concentrator.
Furthermore, the final rule also includes the proposed provision to apply this prior authorization requirement to competitive bidding areas. This means that contracted suppliers will not be exempt from this protocol.
As an industry we have seen many successful accounts of suppliers operating in prior authorization demonstration areas for power mobility devices (PMDs). This new opportunity to expand prior authorization will alleviate burdens faced by suppliers that continually struggle with denials and audits. MiraVista is working through the content of this final rule, and will publish more details in the days ahead.