# 2026-15446: Medicare Refreshes Prior Auth List for Doctor Visits

2026-15446, Medicare Program; Updates to the Master List of Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements; Updates to the Required Face-to-Face Encounter and Written Order Prior to Delivery List; and Updates to the Required Prior Authorization List, is a Federal Register rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2026-07-30, effective 2026-10-28; PRIA reads it as touching household money (as of 2026-08-06).

- Canonical: https://policyrisk.com/federal-register/2026-15446
- As of: 2026-08-06
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Document number: 2026-15446
- Title: Medicare Program; Updates to the Master List of Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements; Updates to the Required Face-to-Face Encounter and Written Order Prior to Delivery List; and Updates to the Required Prior Authorization List
- Type: Rule
- Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services
- Citation: 91 FR 47972
- Published: 2026-07-30
- Effective: 2026-10-28
- Comments close: not stated
- Significant: no
- Touches household money: yes
- Regulation identifier numbers: 0938-ZC04
- Last updated: 2026-08-06

## In one line

Medicare Refreshes Prior Auth List for Doctor Visits

## Summary

This document announces updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Master List. It also announces updates to the HCPCS codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List and the Required Prior Authorization List.

## Effects PRIA read

- More DMEPOS Items Added to Master List: mixed, low. CMS added 20 HCPCS codes to the Master List on October 28, 2026, and updated the CY2026 payment thresholds so the adjusted purchase threshold is $614 and the adjusted monthly rental threshold is $62. Of the 20 additions, 8 codes (including A4239, A6022, A6197, K0831, L0456, L0486, L1833, L3916) wer…
- New Face-to-Face Encounter Requirement: cost, medium. CMS is adding 22 HCPCS codes to the Required Face-to-Face Encounter and Written Order Prior to Delivery List effective October 28, 2026. For these items (for example, certain wheelchairs, orthoses, home ventilators, oxygen systems, and an air-fluidized bed), the treating practitioner must have a fa…
- New Prior Authorization Requirements for Selected DME: cost, medium. CMS added 8 HCPCS codes to the Required Prior Authorization List; these will require a prior authorization request (including written order, medical record evidence, and supplier documentation) before the item is provided and the claim submitted. Implementation (excluding upper limb orthoses) is ef…

## Related documents

- [2026-20281](https://policyrisk.com/federal-register/2026-20281): Global Benchmark for Efficient Drug Pricing (GLOBE) Model, 2026-10-02
- [2026-20131](https://policyrisk.com/federal-register/2026-20131): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-10-01
- [2026-19959](https://policyrisk.com/federal-register/2026-19959): Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Prog…, 2026-09-30
- [2026-20067](https://policyrisk.com/federal-register/2026-20067): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction, 2026-09-30
- [2026-19946](https://policyrisk.com/federal-register/2026-19946): Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospectiv…, 2026-09-29
- [2026-15686](https://policyrisk.com/federal-register/2026-15686): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements, 2026-08-03

## Sources
- [2026-15446 on federalregister.gov](https://www.federalregister.gov/documents/2026/07/30/2026-15446/medicare-program-updates-to-the-master-list-of-items-potentially-subject-to-face-to-face-encounter)
- [2026-15446 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-07-30/pdf/2026-15446.pdf)

## Related
- [Previous: 2026-15434, Procedures for Submission and Consideration of Petitions for Rulemaking](https://policyrisk.com/federal-register/2026-15434)
- [Next: 2026-15455, Airworthiness Directives; Airbus SAS Airplanes](https://policyrisk.com/federal-register/2026-15455)
- [All Federal Register documents](https://policyrisk.com/federal-register)

Source: PRIA, https://policyrisk.com/federal-register/2026-15446 (as of 2026-08-06).