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Important Reminder from Jurisdiction B DME MAC on Required Prior Authorizations


Effective for dates of service on and after August 3, 2020, CMS will discontinue exercising enforcement discretion and resume the requirement to prior authorize certain Power Mobility Devices (PMDs) and Pressure Reducing Support Surfaces (PRSS).

Additionally, the implementation of required PA for Lower Limb Prostheses HCPCS codes: L5856, L5857, L5858, L5973, L5980 and L5987 will begin for dates of service on or after September 1, 2020 in the states of California, Michigan, Pennsylvania, and Texas. Suppliers may begin submitting PA requests for the affected codes and states on or after August 18, 2020 in anticipation of delivering the item on or after September 1, 2020.

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