Change in Prior Authorization Administration for Durable Medical Equipment Services, Effective March 1, 2026
Jan. 29, 2026
Effective March 1, 2026, HealthSpring will manage prior authorizations for durable medical equipment services, as well as orthotic and prosthetic codes.
EviCore healthcare will continue to manage prior authorizations for durable medical equipment services through Feb. 28, 2026.
What this means to your patients through Feb. 28, 2026
Submit prior authorization requests with dates of service before March 1, 2026, to EviCore as usual.
Continue to refer to EviCore for the most updated prior authorization code lists.
There are no changes to the claims submission or appeals processes.
Key changes effective March 1, 2026
Submit prior authorization requests to HealthSpring for dates of services beginning March 1, 2026. Request prior authorization through Availity® Essentials, our provider portal.
Any authorization issued prior to March 1 will remain valid for those dates and services. That means, any authorizations approved by EviCore before March 1 will remain effective with HealthSpring. You do not need to submit a new prior authorization request.
Durable medical equipment providers will submit prior authorization requests directly to HealthSpring.
Refer to clinical review for a list of procedural codes requiring prior authorization.
How to request prior authorization
Request prior authorization through our provider portal, Availity Essentials. This portal is the preferred and fastest method. Refer to Availity for instructions on setting up an account and navigating the portal.
Additional information
Refer to this flyer for information on this change.