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

Document Headings Document headings vary by document type but may contain the following: the agency or agencies that issued and signed a document the number of the CFR title and the number of each part the document amends, proposes to amend, or is directly related to the agency docket number / agency internal file number the RIN which identifies each regulatory action listed in the Unified Agenda of Federal Regulatory and Deregulatory Actions See the Document Drafting Handbook for more details. Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 410 and 414 [CMS-6109-N] RIN 0938-ZC04 AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: 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 (the “Master List”); Updates to the Required Face-to-Face Encounter and Written Order Prior to Delivery List; and Updates to the Required Prior Authorization List. 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. DATES: Implementation of updates to the Master List, the Required Face-to-Face Encounter and Written Order Prior to Delivery List, and the Required Prior Authorization List, excluding upper limb orthoses, are effective October 28, 2026. Prior authorization requirements for the upper limb orthoses will be implemented in three phases. Phase one includes New York, Michigan, Florida, and California and is effective October 28, 2026. Phase two includes the States in phase one and Pennsylvania, Massachusetts, Ohio, Illinois, Texas, Georgia, Arizona, and Oregon and is effective January 26, 2027. Phase three includes all S…