CMS expands power mobility device prior authorization to 12 more states

Why This Topic Matters

Power mobility device claims can be affected by state-based prior authorization policies, so billing and documentation teams need to know where the requirement applies and what supporting records are expected. The article also highlights operational issues that may affect claim processing, supplier submissions, and readiness for review.

Article Sections

1. Expanded prior authorization states and effective date

   Overview of the additional states included in the CMS prior authorization program and when the requirement takes effect. The section also places the expansion in the context of the states already participating in the demonstration.

2. Documentation and request process

   General discussion of the documentation package used to support a prior authorization request for power mobility devices. The section addresses provider, supplier, and submission workflow considerations at a broad level.

3. Tips to bolster PMD documentation

   A brief set of general documentation focus areas intended to help reduce request denials. The section summarizes common review themes without providing detailed coding or decision criteria.