Audits and Condition of Payment Prior Authorization Resume August 3!

Published in Complex Rehab on July 10, 2020

Please see the attached notification from CMS regarding audits and the condition of payment prior authorization. On August 3, audits will resume from the suspension during the public health emergency. In addition, items requiring prior authorization (Power Wheelchair Bases and Pressure Reducing Support Surfaces) with an initial date of service August 3 must have a prior authorization. This was temporarily optional during the public health emergency, but that option will end with initial dates of service August 3. 

Please see the complete CMS release here.

If you have any questions please contact Dan Fedor at dan.fedor@vgm.com or 570-499-8459.


TAGS

  1. audits
  2. billing & reimbursement
  3. complex rehab
  4. vgm

From Our Experts

Optimizing Your Business for the Future thumbnail Optimizing Your Business for the Future Learn how home-based care providers can optimize operations, technology, and compliance with VGM's latest business playbook. EZ-ACCESS Vendor Partner Spotlight | Breaking Down Barriers thumbnail EZ-ACCESS Vendor Partner Spotlight | Breaking Down Barriers Discover how EZ-ACCESS, a longtime VGM vendor partner for nearly 40 years, is helping people age in place and regain mobility through access solutions. VGM Heartland Conference | Celebrate 25 Years of Community thumbnail VGM Heartland Conference | Celebrate 25 Years of Community Join fellow CRT and home healthcare professionals at the 2026 VGM Heartland Conference in Waterloo, Iowa. Celebrate 25 years of education, connection, and community at Heartland High. Matt Filippis Named Director of Business Development at VGM thumbnail Matt Filippis Named Director of Business Development at VGM VGM & Associates appoints Matt Filippis as Director of Business Development, Clinical Mobility and Accessibility, supporting CRT, home accessibility, and O&P providers. Medicare Telehealth Flexibilities Extended for CRT Providers thumbnail Medicare Telehealth Flexibilities Extended for CRT Providers Learn how the new Medicare telehealth extension impacts CRT providers. U.S. Rehab's Dan Fedor explains why remote care access remains vital through 2027. Why CRT Providers Are Exploring Home Accessibility in 2026 thumbnail Why CRT Providers Are Exploring Home Accessibility in 2026 Home accessibility is emerging as a major growth path for CRT providers. Explore the trend and learn why strategic, low-risk steps matter. Log in for the full article. Cash Flow Strategies for CRT Providers thumbnail Cash Flow Strategies for CRT Providers Explore compliant cash flow strategies for CRT providers to improve reimbursement, reduce denials, and strengthen financial stability. Closing the ATP Gap: Mentorship, Training, and Innovative Recruitment thumbnail Closing the ATP Gap: Mentorship, Training, and Innovative Recruitment Strengthening the CRT workforce starts with robust training, mentorship, and smarter recruitment.