October 28 changes the rules.
Six selected HCPCS codes will require prior authorization nationwide beginning October 28, 2026.
Review these codes: – L0456, L0457, L0486 – L1833 – E0194 – K0005
L3761 and L3916 begin in California, Florida, Michigan, and New York before expanding to additional states and then nationwide.
An item appearing on the DMEPOS Master List alone does not automatically mean prior authorization is required.
Before October 28, review: – Affected HCPCS codes – Authorization requirements – Orders and documentation – Delivery and billing workflow
Reenix Excellence provides DMEPOS billing, prior authorization support, eligibility verification, claims follow-up, denial management, A/R follow-up, and payment posting for U.S. healthcare organizations.
Read the detailed blog for affected HCPCS codes, rollout dates, Medicare requirements, and workflow considerations.
Email: info@reenixexcellence.com Visit: www.reenixexcellence.com Call: +1 607-286-0329