CMS to Offer Prior Authorization Option for PMD Accessories

• By Laurie Watanabe
• Mar 28, 2023

The Centers for Medicare & Medicaid Services (CMS) is starting a voluntary prior-authorization (PA) process for power mobility device (PMD) accessory items. A March 16 notice from Noridian Healthcare Solutions, a Medicare Administrative Contractor, said, “PA [prior authorization] requests for applicable PMD accessories may be submitted for review on or after March 20, 2023, for dates of service on or after April 6, 2023.”

Qualifying PMD accessories include powered seating functions, such as tilt, recline, and elevating legrests; wheelchair trays; alternative driving controls, including mini proportional joysticks, head controls, and sip-and-puff interfaces; electronic interfaces for speech-generating devices; wheelchair seat cushions, including general use, skin protection, positioning, skin protection and positioning, and adjustable; wheelchair backrests; and armrests.

Noting the voluntary nature of the prior authorization, Noridian said, “Suppliers can request a PA review for PMD accessories when submitting on the same PA as the required base item. The PA will be rejected if accessories are submitted separate from the PMD base item PA request.”

The notice added that if the power mobility base is denied during the prior-authorization process, “all accessories will be denied. If the base item has already received an affirmed PA decision and is resubmitted to review the accessories, the PA will be rejected.”

To see the list of affected PMD accessories, click here.

For more information on the prior authorization process, click here.