Pressure-reduction surfaces and devices authorization change

Effective January 1, 2018, Priority Health no longer applies capped rental rules for mattress pads and other pressure-reduction surfaces/devices for codes E0181 – E0187 and E0196 – E0198. These items may now be purchased outright.

These codes will require prior authorization ONLY if the charges exceed our standard DME purchase limits of $1,000 for commercial and Medicare or $500 for Medicaid.

Learn more about DME coverage, authorization and billing.