Medicare DMEPOS prior-auth required check (free)
pa_required_checkCheck whether a HCPCS code requires CMS prior authorization on a given date of service, including state-specific phased-in status and list version.
Instructions
Check whether a HCPCS code is on the current CMS Required Prior Authorization List (42 CFR 414.234) on a date of service (default today). Returns paRequired flag, category, nationwide-since date, and list version. Some items are phased in by state: for those, paRequired is null until a state is given. Original Medicare FFS scope. Free, no API key required.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| code | Yes | HCPCS Level II code (e.g., "E0651") | |
| state | No | 2-letter US state or territory; needed for items phased in by state | |
| dateOfService | No | Date of service, YYYY-MM-DD (default today) |