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July 10, 2024

Orthoses Prior Authorization Updates Reminder

Orthoses Prior Authorization Changes effective August 12, 2024:

  • CMS added six orthoses HCPCS codes to the Required Prior Authorization List. We will begin accepting prior authorization requests for these codes on July 29, 2024:
    • L0631, L0637, L0639, L1843, L1845, L1951
  • CMS removed L1833 from the Required Prior Authorization list.

Orthoses Required Face-to-Face Encounter and Written Order Prior To Delivery (WOPD) Changes effective August 12, 2024:

  • CMS added eight orthoses HCPCS codes to the Required Face-to-Face Encounter and WOPD List:
    • L0635, L0636, L0638, L0639, L0640, L0651, L1845, and L1852
  • CMS removed L1833 from the Required Face-to-Face Encounter and WOPD List.

Learn more about these requirements in MLN Matters Article SE20007External PDF.

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