Notice to Members - Prior Authorization for Power Wheel Chairs

Members & Publications

September 11, 2018

The Academy would like you to be aware that the following notice from CMS became effective on September 1, 2018: “Medicare Program; Update to the Required Prior Authorization List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items That Require Prior Authorization as a Condition of Payment.”  This notice became effective on September 1, 2018.

The purpose of the notice was to inform the public that CMS has updated the Required Prior Authorization List of DMEPOS (durable medical equipment, prosthetics, orthotics, and supplies) to include all power mobility devices. The notice came after a demonstration was done in California, Florida, Illinois, Michigan, New York, North Carolina, and Texas. This information was released as a notice, not a proposal, so there was no formal opportunity to comment.

The Academy has actively been expressing our concerns with prior authorization for certain DMEPOS for years.

Please inform the Academy if you or your practice has issues with this new requirement.

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.