CMS provides new details on prior auth process

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Wednesday, June 5, 2019

WASHINGTON – CMS will turn around requests for prior authorizations for support surfaces in five business days, the agency announced during a Special Open Door Forum on Tuesday.

CMS will turn around expedited requests in two days, it says.

Starting July 22, providers in four states—California, Indiana, New Jersey and North Carolina—will have to submit prior authorization requests for five codes for support surfaces. Starting Oct. 21, providers in all states will have to submit prior authorization requests for E0193, E0277, E0371, E0372 and E0373.

During the forum, CMS notified providers of an operational guide on the prior authorization process that has been updated with information on support surfaces.

Providers will also have to submit prior authorization requests for seven codes for complex rehab power mobility devices starting in July: K0857, K0858, K0859, K0860, K0862, K0863, K0864.