10/28/2026
Medicare Prior Authorization Updates: October 28, 2026
Another round of Medicare prior authorization requirements takes effect this month, impacting DMEPOS suppliers nationwide.
Effective October 28, 2026:
- Nationwide prior authorization requirements begin for HCPCS codes L0456, L0457, L0486, and L1833.
- Two upper extremity orthoses, L3761 and L3916, will be added to prior authorization requirements through a phased rollout.
Implementation timeline for L3761 and L3916:
- Phase 1 | October 28, 2026: NY, MI, FL, and CA
- Phase 2 | January 26, 2027: PA, MA, OH, IL, TX, GA, AZ, and OR
- Phase 3 | April 26, 2027: Nationwide
Make sure your team is prepared for these changes and understands which requirements apply to your location.
View the required prior authorization list for additional details.
https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/DMEPOS/Downloads/DMEPOS_PA_Required-Prior-Authorization-List.pdf