CMS set to launch probation period for new suppliers, new owners
By HME News Staff
Updated 8:38 AM CDT, Wed September 9, 2026
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) is implementing a nationwide, one-year probationary period for newly enrolled DMEPOS suppliers and those undergoing changes of ownership starting Oct. 15, 2026.
Under Probationary Prior Authorization (PPA), these suppliers must submit prior authorization requests (PARs) for specific HCPCS codes
“Prior authorization allows suppliers to ensure that a DMEPOS item meets applicable Medicare coverage, payment, and coding rules before items are delivered,” the agency stated. “This advance review helps to protect the Medicare Trust Fund from improper payments while ensuring that beneficiaries can receive the DMEPOS items they need in a timely manner.”
Items that will 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
The Probationary Prior Authorization process will follow the same submission and review steps as the established prior authorization process for certain DMEPOS items.
CMS notes that the Probationary Prior Authorization process does not replace the existing prior authorization process for certain DMEPOS items and suppliers participating in that process must continue to comply with existing prior authorization requirements for applicable DMEPOS items.
FMI: Visit the DMEPOS Prior Authorization webpage and see the full list of codes requiring prior authorization.
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