Medicare to eliminate pre-auth requirements for some DME beginning Jan 1, 2023

Effective January 1, 2023, Medicare is eliminating certificates of medical necessity (CMN) and durable medical equipment information forms (DIF) for some services.

If either a CMN or DIF is submitted with claims for dates of service January 1, 2023, or later will be rejected and returned to you.

If after January 1, 2023, you need to submit or resubmit a claim for a date of service before January 1, 2023, you will still need to include both the CMN and DIF if they are not on file from a previous claim, so your claim will process.

Services that do not need CMNs or DIFs for dates of service Jan 1, 2023, and after include:

  • CMS-484 - Oxygen
  • CMS-846 - Pneumatic Compression Devices
  • CMS-847 - Osteogenesis Stimulators
  • CMS-848 - Transcutaneous Electrical Nerve Stimulators
  • CMS-849 - Seat Life Mechanisms
  • CMS-854 - Section C Continuation Form
  • CMS-10125 - External Infusion Pumps
  • CMS-10126 - Enteral and Parenteral Nutrition

You can find additional information on MLN Matters Number SE22002.