Tools / Required PA List lookup
Is this HCPCS code on the Required Prior Authorization List?
CMS requires a prior-authorization decision before delivery for a specific list of DMEPOS codes, and the list grows a few times a year. Type a code to see whether it is on the list, the date it took effect, and — for codes CMS phases in by state — where it applies today.
Enter a code above.
Coming additions
Codes CMS has announced that are not yet in force everywhere as of Oct 11, 2026. Prior authorization applies to dates of service on or after each date.
L0456 TLSO flexible, rigid posterior panel, custom fitted
Orthoses (braces).
CMS notice L0486 TLSO triplanar, two-piece rigid shell, custom fabricated
Orthoses (braces).
CMS notice L1833 KO adjustable knee joints, positional, rigid, OTS
Orthoses (braces).
CMS notice L3761 Elbow orthosis, adjustable position locking joint(s), OTS
Orthoses (braces).
Phased in by state: Oct 28, 2026 — NY, MI, FL, CA; Jan 26, 2027 — PA, MA, OH, IL, TX, GA, AZ, OR; Apr 26, 2027 — all remaining states .
CMS notice L3916 WHO, nontorsion joint(s), elastic bands, turnbuckles, OTS
Orthoses (braces).
Phased in by state: Oct 28, 2026 — NY, MI, FL, CA; Jan 26, 2027 — PA, MA, OH, IL, TX, GA, AZ, OR; Apr 26, 2027 — all remaining states .
CMS noticeThe full list, by category
82 codes. Effective date is the first date prior authorization applied anywhere; phased codes show their state schedule.
Power mobility devices 46
| Code | Description | Effective |
|---|---|---|
K0800 | POV group 1 standard ≤300 lb | Apr 13, 2022 |
K0801 | POV group 1 heavy duty 301–450 lb | Apr 13, 2022 |
K0802 | POV group 1 very heavy duty 451–600 lb | Apr 13, 2022 |
K0806 | POV group 2 standard ≤300 lb | Apr 13, 2022 |
K0807 | POV group 2 heavy duty 301–450 lb | Apr 13, 2022 |
K0808 | POV group 2 very heavy duty 451–600 lb | Apr 13, 2022 |
K0813 | PWC group 1 standard portable, sling/solid seat ≤300 lb | Sep 1, 2018 |
K0814 | PWC group 1 standard portable, captain chair ≤300 lb | Sep 1, 2018 |
K0815 | PWC group 1 standard, sling/solid seat ≤300 lb | Sep 1, 2018 |
K0816 | PWC group 1 standard, captain chair ≤300 lb | Sep 1, 2018 |
K0820 | PWC group 2 standard portable, sling/solid ≤300 lb | Sep 1, 2018 |
K0821 | PWC group 2 standard portable, captain ≤300 lb | Sep 1, 2018 |
K0822 | PWC group 2 standard, sling/solid ≤300 lb | Sep 1, 2018 |
K0823 | PWC group 2 standard, captain ≤300 lb | Sep 1, 2018 |
K0824 | PWC group 2 heavy duty, sling/solid 301–450 lb | Sep 1, 2018 |
K0825 | PWC group 2 heavy duty, captain 301–450 lb | Sep 1, 2018 |
K0826 | PWC group 2 very heavy duty, sling/solid 451–600 lb | Sep 1, 2018 |
K0827 | PWC group 2 very heavy duty, captain 451–600 lb | Sep 1, 2018 |
K0828 | PWC group 2 extra heavy duty, sling/solid ≥601 lb | Sep 1, 2018 |
K0829 | PWC group 2 extra heavy duty, captain ≥601 lb | Sep 1, 2018 |
K0835 | PWC group 2 standard, single power option, sling/solid ≤300 lb | Sep 1, 2018 |
K0836 | PWC group 2 standard, single power option, captain ≤300 lb | Sep 1, 2018 |
K0837 | PWC group 2 heavy duty, single power option, sling/solid 301–450 lb | Sep 1, 2018 |
K0838 | PWC group 2 heavy duty, single power option, captain 301–450 lb | Sep 1, 2018 |
K0839 | PWC group 2 very heavy duty, single power option, sling/solid 451–600 lb | Sep 1, 2018 |
K0840 | PWC group 2 extra heavy duty, single power option, sling/solid ≥601 lb | Sep 1, 2018 |
K0841 | PWC group 2 standard, multiple power option, sling/solid ≤300 lb | Sep 1, 2018 |
K0842 | PWC group 2 standard, multiple power option, captain ≤300 lb | Sep 1, 2018 |
K0843 | PWC group 2 heavy duty, multiple power option, sling/solid 301–450 lb | Sep 1, 2018 |
K0848 | PWC group 3 standard, sling/solid ≤300 lb | Sep 1, 2018 |
K0849 | PWC group 3 standard, captain ≤300 lb | Sep 1, 2018 |
K0850 | PWC group 3 heavy duty, sling/solid 301–450 lb | Sep 1, 2018 |
K0851 | PWC group 3 heavy duty, captain 301–450 lb | Sep 1, 2018 |
K0852 | PWC group 3 very heavy duty, sling/solid 451–600 lb | Sep 1, 2018 |
K0853 | PWC group 3 very heavy duty, captain 451–600 lb | Sep 1, 2018 |
K0854 | PWC group 3 extra heavy duty, sling/solid ≥601 lb | Sep 1, 2018 |
K0855 | PWC group 3 extra heavy duty, captain ≥601 lb | Sep 1, 2018 |
K0856 | PWC group 3 standard, single power option, sling/solid ≤300 lb · phased by state | Mar 20, 2017 |
K0857 | PWC group 3 standard, single power option, captain ≤300 lb | Jul 22, 2019 |
K0858 | PWC group 3 heavy duty, single power option, sling/solid 301–450 lb | Jul 22, 2019 |
K0859 | PWC group 3 heavy duty, single power option, captain 301–450 lb | Jul 22, 2019 |
K0860 | PWC group 3 very heavy duty, single power option, sling/solid 451–600 lb | Jul 22, 2019 |
K0861 | PWC group 3 standard, multiple power option, sling/solid ≤300 lb · phased by state | Mar 20, 2017 |
K0862 | PWC group 3 heavy duty, multiple power option, sling/solid 301–450 lb | Jul 22, 2019 |
K0863 | PWC group 3 very heavy duty, multiple power option, sling/solid 451–600 lb | Jul 22, 2019 |
K0864 | PWC group 3 extra heavy duty, multiple power option, sling/solid ≥601 lb | Jul 22, 2019 |
Pressure reducing support surfaces 6
| Code | Description | Effective |
|---|---|---|
E0193 | Powered air flotation bed (low air loss) · phased by state | Jul 22, 2019 |
E0194 | Air fluidized bed | Oct 28, 2026 |
E0277 | Powered pressure-reducing air mattress · phased by state | Jul 22, 2019 |
E0371 | Non-powered advanced pressure reducing overlay · phased by state | Jul 22, 2019 |
E0372 | Powered air overlay for mattress · phased by state | Jul 22, 2019 |
E0373 | Non-powered advanced pressure reducing mattress · phased by state | Jul 22, 2019 |
Lower limb prostheses 6
| Code | Description | Effective |
|---|---|---|
L5856 | Endoskeletal knee-shin, microprocessor swing+stance · phased by state | Sep 1, 2020 |
L5857 | Endoskeletal knee-shin, microprocessor swing only · phased by state | Sep 1, 2020 |
L5858 | Endoskeletal knee-shin, microprocessor stance only · phased by state | Sep 1, 2020 |
L5973 | Endoskeletal ankle-foot, microprocessor · phased by state | Sep 1, 2020 |
L5980 | Flex foot system · phased by state | Sep 1, 2020 |
L5987 | Shank foot system w/ vertical loading pylon · phased by state | Sep 1, 2020 |
Orthoses (braces) 21
| Code | Description | Effective |
|---|---|---|
L0456 | TLSO flexible, rigid posterior panel, custom fitted | Oct 28, 2026 |
L0457 | TLSO flexible, rigid posterior panel, OTS | Oct 28, 2026 |
L0486 | TLSO triplanar, two-piece rigid shell, custom fabricated | Oct 28, 2026 |
L0631 | LSO sagittal, rigid ant/post panels, custom fitted | Aug 12, 2024 |
L0637 | LSO sagittal-coronal, rigid ant/post frame, custom fitted | Aug 12, 2024 |
L0639 | LSO sagittal-coronal, rigid shell(s), custom fitted | Aug 12, 2024 |
L0648 | LSO sagittal, rigid ant/post panels, OTS · phased by state | Apr 13, 2022 |
L0650 | LSO sagittal-coronal, rigid ant/post frame, OTS · phased by state | Apr 13, 2022 |
L0651 | LSO sagittal-coronal, rigid shell(s), OTS | Apr 13, 2026 |
L1832 | KO adjustable knee joints, positional, rigid, custom fitted · phased by state | Apr 13, 2022 |
L1833 | KO adjustable knee joints, positional, rigid, OTS | Oct 28, 2026 |
L1843 | KO single upright, ML+rotation control, custom fitted | Aug 12, 2024 |
L1844 | KO single upright, ML+rotation control, custom fabricated | Apr 13, 2026 |
L1845 | KO double upright, ML+rotation control, custom fitted | Aug 12, 2024 |
L1846 | KO double upright, ML+rotation control, custom fabricated | Apr 13, 2026 |
L1851 | KO single upright, ML+rotation control, OTS · phased by state | Apr 13, 2022 |
L1852 | KO double upright, ML+rotation control, OTS | Apr 13, 2026 |
L1932 | AFO rigid anterior tibial section, carbon fiber, custom fitted | Apr 13, 2026 |
L1951 | AFO spiral (IRM type), prefabricated | Aug 12, 2024 |
L3761 | Elbow orthosis, adjustable position locking joint(s), OTS · phased by state | Oct 28, 2026 |
L3916 | WHO, nontorsion joint(s), elastic bands, turnbuckles, OTS · phased by state | Oct 28, 2026 |
Pneumatic compression devices 2
| Code | Description | Effective |
|---|---|---|
E0651 | Pneumatic compressor, segmental, w/o calibrated gradient | Apr 13, 2026 |
E0652 | Pneumatic compressor, segmental, w/ calibrated gradient | Apr 13, 2026 |
Manual wheelchairs 1
| Code | Description | Effective |
|---|---|---|
K0005 | Ultra-lightweight manual wheelchair | Oct 28, 2026 |
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Source: CMS, "Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items" and the Federal Register notices linked per entry. Verified Oct 11, 2026. Being on this list means a prior-authorization request is a condition of payment; it does not change the coverage criteria in the applicable LCD. Not legal or billing advice.