Policy & oversight
Medicare Equipment Suppliers That Recently Enrolled Face Prior Authorization on Certain Items Starting October 15
A probationary prior authorization program takes effect October 15 for DMEPOS suppliers that joined Medicare after the six-month enrollment moratorium lifted in late August, adding an approval step before Medicare pays for certain covered items.
By the Goodsurance editorial teamSeptember 9, 2026
Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers that enrolled in Medicare after August 27, 2026, when a six-month nationwide enrollment moratorium lifted, will be subject to a probationary prior authorization requirement for certain items starting October 15, 2026.
Under the program, which CMS established through its December 2025 final rule, suppliers with new Medicare enrollments and those undergoing certain changes of ownership must obtain advance CMS approval before Medicare will pay for specific DMEPOS items they supply. The requirement is designed to limit a recognized pattern of improper billing from newly opened supplier locations in the period immediately following enrollment.
New Medicare equipment suppliers face mandatory prior authorization for certain items starting October 15, following the August moratorium lift.
Suppliers can earn an exemption from the probationary requirement by maintaining a provisional affirmation rate of 90 percent or higher, demonstrating consistent compliance with Medicare coverage, coding, and payment rules.
The DMEPOS category covers products that many Medicare beneficiaries use at home, including wheelchairs, walkers, oxygen supplies, hospital beds, continuous positive airway pressure devices, and orthotic braces. The prior authorization step means a supplier must receive CMS approval before delivering an item and billing Medicare, which can add processing time to a request.
Beneficiaries who are arranging covered equipment through a supplier that enrolled recently should allow additional time for the supplier to complete the prior authorization process. CMS notes that beneficiaries can verify a supplier's Medicare participation status through Medicare.gov.
In plain words
If a Medicare equipment company just opened or recently changed ownership, it must now get Medicare's permission before it can deliver some products to you and get paid. This rule starts October 15, 2026. It covers things like wheelchairs, walkers, oxygen supplies, and braces. If you are waiting for equipment from a new supplier, the process might take a little longer because of this approval step. You can check whether a supplier takes Medicare at Medicare.gov.
Understand the basics first
Source: CMS
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