Medicare Will Require Advance Approval for Certain Braces, Pressure Pads, and Manual Wheelchairs Starting October 28

CMS announced in late July 2026 that it is expanding the Medicare required prior authorization program for durable medical equipment, prosthetics, orthotics, and supplies. The agency added 20 items to the Master List of DMEPOS Items Potentially Subject to Conditions of Payment, a billing-pattern surveillance watchlist, and selected eight additional product categories for required prior authorization, with changes taking effect October 28, 2026. The newly added prior authorization items include certain orthoses, pressure reducing support surfaces, and manual wheelchair bases. Under required prior authorization, a treating physician must submit clinical documentation to Medicare before the equipment is delivered to the patient. If the request is not approved in advance, Medicare will not pay for the item. CMS applies required prior authorization to home medical equipment categories that have historically seen elevated rates of improper billing. The Medicare Learning Network newsletter confirmed the additions on July 30, 2026. Beneficiaries who expect to need any of these items before year-end should work with their physician or equipment supplier to start the authorization process well before October 28 to avoid delivery delays or denied claims. CMS also added 22 items to a separate list that requires a face-to-face visit and a written order before the equipment is delivered.