The Centers for Medicare & Medicaid Services (CMS) recently published updates in the Federal Register regarding Healthcare Common Procedure Coding System (HCPCS) codes on the Master List that will require prior authorization effective April 13, 2026. The following are the codes on this list that pertain to lower-limb orthoses:
- L1844: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated
- L1846: Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated
- L1852: Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial- lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
- L1932: Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment.
The following codes pertaining to the lower limb are eligible to be added in the future:
- L-2999: Lower extremity orthoses, not otherwise specified •
- L-5783: Addition to lower extremity, user adjustable, mechanical, residual limb volume management system
- L-5841: Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control
To read the update, visit www.federalregister.gov/documents/2026/01/13/2026-00487/medicare-program-updates-to-the-master-list-of-items-potentially-subject-to-face-to-face-encounter.
