CMS Will Require Prior Authorization Process for Newly Enrolled Suppliers of Certain DMEPOS Suppliers
Published: 09/11/2026
Sources:
- Centers for Medicare and Medicaid Services
Relevant To:
- Ambulatory Surgical Centers,
- Rural Emergency Hospitals,
- Assisted Living,
- Urgent Care,
- Medical Office,
- Critical Access Hospitals,
- Home Health,
- Hospitals,
- Ambulatory Care,
- Hospice,
- Rural Health Clinics,
- Durable Medical Equipment (DME)
Beginning October 15, 2026, CMS will require probationary prior authorization for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items billed by newly enrolled suppliers and suppliers undergoing certain changes in ownership.
This program is authorized under Section 1866(j)(3) of the Social Security Act and 42 CFR §424.527, which establishes a one-year probationary period for newly enrolled and ownership-changing DMEPOS suppliers.
Prior authorization allow…
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