CMS DMEPOS probationary prior auth starts October 15 for new and CHOW suppliers

On September 10, 2026, CMS MLN Connects told suppliers that DMEPOS Probationary Prior Authorization starts October 15. The CMS PPA process page (last Update 9/1/2026) already set the operational rules and points to the Probationary Prior Authorization List PDF.

EFFECTIVE DATE: October 15, 2026 for dates of service on or after that day for items on the Probationary Prior Authorization List.

This is a supplier-enrollment and prior-auth stack story for the CMS Watch desk. It is not a rewrite of the live October 2026 DMEPOS required PA and face-to-face list (effective October 28). Keep both lists next to each other on the desk.

What starts October 15

CMS will:

• Implement a nationwide 1-year probationary prior authorization (PPA) process for newly enrolled DMEPOS suppliers and suppliers undergoing a change of ownership
• Require prior authorization as a condition of payment for certain DMEPOS items on the Probationary Prior Authorization List (PDF) with dates of service on or after October 15, 2026

Authority cited on the PPA page is Section 1866(j)(3) of the Social Security Act and 42 CFR 424.527. The one-year probationary period begins when a supplier submits their first bill for one of the DMEPOS items on that Probationary Prior Authorization List.

Who is in scope

PPA applies to:

• Newly enrolled DMEPOS suppliers
• Suppliers undergoing certain changes of ownership

effective on or after October 15, 2026.

MLN Connects also reminds new and change-of-ownership suppliers that they remain subject to regular program oversight initiatives, including required prior authorization, face-to-face encounter, and written order prior to delivery requirements that already sit on the DMEPOS stack.

CMS warns on the PPA page that newly enrolled DMEPOS suppliers must also participate in the wider required prior authorization process for certain high-risk DMEPOS items. PPA does not replace that existing process.

The Probationary Prior Authorization List

The September 1, 2026 PDF lists 40 HCPCS codes, all with effective date 10/15/2026. The list is mostly spinal and extremity orthoses, plus two osteogenesis stimulators:

That table is a sample only. Confirm the full 40-code set in the official PDF before you change a charge master or PA workflow. CMS says it may update the list if new vulnerabilities arise and will post changes on the PPA webpage.

Use the encoder or code book when you need the full HCPCS descriptor for an orthosis or stimulator on a claim.

How PPA relates to the existing DMEPOS PA program

The PPA process follows the same submission and review steps as the established Prior Authorization Process for Certain DMEPOS Items. CMS points suppliers to the current DMEPOS PA Operational Guide (PDF).

Two desks, two lists:

Suppliers in PPA must still meet the existing required prior authorization rules for any applicable DMEPOS items on that separate list.

What billers and DME desks should do now

• Pull the September 1, 2026 PPA PDF and mark every HCPCS you stock or bill.
• For any newly enrolled or CHOW supplier NPI, confirm whether PPA starts on the first claim for a listed item on or after October 15, 2026.
• Keep required PA, face-to-face encounter, and written-order-prior-to-delivery checklists in the same workflow, not as a substitute for PPA.
• Do not confuse October 15 PPA with the October 28 required PA and face-to-face list updates already covered on CMS Watch.
• When a claim denies for missing PA on a listed orthosis or stimulator, re-check which list and which enrollment status applied on the date of service.

This page stays on the probationary process CMS printed in MLN Connects (September 10, 2026) and on the PPA webpage (Update 9/1/2026). It is not a CMS-HCC, V28, or RADV documentation change.