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September 22, 2022

Orthoses Prior Authorization – Phase 3

Orthoses Prior Authorization Phase 3 begins October 10, 2022, in Alabama, Alaska, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming, the Virgin Islands, Puerto Rico, American Samoa, Guam, and the Northern Mariana Islands.

The DME MACs will begin began accepting Prior Authorization (PA) requests for these states and territories for the L0648, L0650, L1832, L1833, and L1851 codes on September 26, 2022.

Helpful information including What Suppliers Need to Know, Reasons for Non-Affirmed Prior Authorizations, Documentation Checklists, Look-Up Tools, and more is available on the CGS Prior Authorization page.

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