CMS Finalizes Updates to DME Face-to-Face, Prior Authorization Master List

CMS has finalized the annual update to the Master List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items that are potentially subject to a face-to-face encounter, a written order prior to delivery, and/or prior authorization. The agency also updated the Required Prior Authorization List and the Required Face-to-Face Encounter and Written Order Prior to Delivery List. These changes dictate which specific HCPCS codes will be subject to these requirements in the coming year, impacting suppliers and ordering providers. Billing teams for DME suppliers and referring practices must cross-reference the new lists against their product catalogs and update internal compliance checklists. The rule is effective upon publication; claims for newly added items submitted without the mandated documentation will be denied.