Authorizations for DMEPOS services for Medicaid members

For services beginning on July 1, 2024, prior authorization requests for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services in place of service 12 (home), 13 (assisted facility living), and 14 (group home) will be reviewed by Carelon Post Acute Solutions, LLC. The goal of this program is to ensure members receive the right product for the right duration of time in the home. This change will be applicable to the following markets: Maryland Medicaid, Missouri Medicaid, and Wisconsin Medicaid.

How to submit or check a prior authorization request

For DMEPOS services, Carelon Post Acute Solutions will begin receiving requests on July 1, 2024, for dates of service on or after July 1, 2024.

To request authorization, select here to get started. You can upload clinical information and check the status of your requests through this online tool seven days a week, 24 hours a day. If you are unable to use the online tool, you can call the Carelon Post Acute Solutions Provider Call Center during normal operating hours from 7 a.m. to 7 p.m. CT, Monday through Friday, or send a fax to Carelon Post Acute Solutions at the numbers below:

To learn more about Carelon Post Acute Solutions and upcoming training webinars, visit the website or email DMEprovider_relations@carelon.com.

If you have additional questions, please call the Carelon Post Acute Solutions Provider Call Center at 844-411-9622, option 6, then option 6 again for DMEPOS.