Medicare prior authorization now required for eight more DMEPOS codes, including K0005

CMS added eight HCPCS codes to the Required Prior Authorization List with a nationwide start date of October 28, 2026: K0005 (manual wheelchair base), E0194 (pressure reducing support surface), L1833 (knee orthosis) and L0456, L0457 and L0486 (thoracic lumbar sacral orthoses). Two upper limb orthosis codes, L3761 and L3916, phase in by state: California, Florida, Michigan and New York on October 28, 2026, then Arizona, Georgia, Illinois, Massachusetts, Ohio, Oregon, Pennsylvania and Texas on January 26, 2027, then nationwide on April 26, 2027. CMS announced the update in the Federal Register on July 30, 2026 (document 2026-15446); the codes already on the list are unchanged.

Why it matters. Suppliers billing K0005 chairs or these orthoses for dates of service on or after October 28 need an affirmed prior authorization decision on file before the claim pays.