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DMEPOS standard program — official procedure references

DMEPOS potential-selection inventory: 550 unique HCPCS-II identifiers are in this published master inventory. Membership alone does not impose prior authorization or face-to-face/WOPD requirements; consult separately selected lists and dates. Pre-delivery documentation: The request includes the order, relevant medical record and supplier documentation. Relevant medical record evidence concerns care before delivery. Provisional decision is not payment determination: Affirmation is preliminary. The PA decision is not itself appealable; a submitted and denied claim has a separate appeal process. Representative-payee exception is limited: The initial implementation exception ends at national implementation and does not apply to items added to an existing program. CMS specifically states L3761 and L3916 require PA regardless of representative-payee status. Supplier exemption needs jurisdiction-specific notice: A provisional affirmation rate of at least ninety percent per MAC jurisdiction may qualify, but exemption is established by notice and reviewed annually. Do not infer exemption from a self-reported rate. Source checked 2026-10-15. Documentary verification only; no clinical review or individual coverage determination.

Prior authorization: unknown. Member-specific applicability must be checked with the payer.
PayerCMS / Medicare
Plan contextOriginal Medicare — reference context only
ServiceDMEPOS standard program
State scopeNot verified
Effective dateNot verified
RevisionSource 2ea59299e7b8
Retrieved10/15/2026
EvidenceOpen original source ↗

Source evidence

Documentary checks establish what the official source says, not clinical eligibility.

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This public reference is available in full above. Paid research tools are not currently available; no clinical checklist or cross-payer authorization determination is included.

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Evidence fingerprint: 2ea59299e7b8d160eea03d54deec916bb4be5b1344a50665da6e817350587780